Pulvinotomy was performed on 42 cases with intractable pain. 19 cases survived for more than 1 year, the results were classified as follows: 4 were excellent, 4 good, 5 fair, and 4 were poor. The effects of the operation are discussed based on the disease. 2 cases, who survived for more than 1 year, suffered from the pain due to infiltration or metastasis of cancer, they died 22 and 14 months after the operation, respectively, but they had no intractable pain during the year before death. 14 cases who underwent CVD survived for more than 1 year. Results of the operation were as follows: 3 were excellent; 4 good, 4 fair, and 4 were poor. These cases were followed up for 3-10 years and the average was about 5 years. After more than 1 year, 2 cases with atypical facial pain were considered as being either fair or poor, one (fair case) of whom still does routine housework and is not drug dependent. A case of causalgia has been free from pain for 5 years after the operation.