We have reviewed the outcome of patients who have undergone thalamotomy for the intention tremor of multiple sclerosis (MS). Twenty-four patients underwent 29 procedures between 1988 and 1995. These patients were assessed for the degree of disability due to MS and for the impairment of arm function due to the tremor. Preoperative, postoperative and last follow-up score (mean 2.2 years) were determined for arm function following thalamotomy. Patient satisfaction, where expressed, was recorded. Twenty-three procedures (79%) resulted in immediate improvement in arm function. Thirteen complications were recorded. Postoperative fatigue was demonstrated after seven procedures. Sustained benefit was seen after 18 procedures (62%). Out of 23 patients whose opinions are recorded four were enthusiastic and 10 satisfied with the outcome. We conclude that, despite severe disability, a majority of patients with intention tremor of MS may still benefit from thalamotomy and are satisfied with the results.