We report our long term experience with 27 patients treated intrathecally (i.th.) with baclofene for spasticity of spinal or cerebral origin. Patients were followed for up to 132 month after implantation. They showed a significant decrease of spasticity (Asworth 3.5 to 1.7) and of pain (6.1 to 2.2 on a visual analogue scale (VAS)). Most patients and caregivers were satisfied with the treatment, only 2 patients stopped infusion. One patient was treated in combination with i.th. morphine and in 4 patients baclofene treatment was complemented with botulinum toxin. Seven patients developed a total of 12 complications related either to the device (dislocation or disconnection of the catheter (4) skin perforation by the pump) or symptoms of baclofene withdrawl or overdosage. Seven patients died of secondary complications of multiple sclerosis or heard infarction. No death could be attributed to intrathecal therapy. Intrathecal baclofene application is a safe and effective therapy of long duration but requires a consent indication and careful supervision.