Abstract Casualties from the Republic of Vietnam conflict have again, as after every war, drawn our attention sharply to the problem of post-traumatic causalgia. Twenty-three cases of causalgia of the upper extremity are presented. The diagnosis and management, both surgical and nonsurgical, are discussed. The surgical approach that has given uniformly good results has been transthoracic dorsal sympathectomy of the lower half of the stellate ganglion through the sympathetic ganglia at the level of the fourth or fifth thoracic vertebra. A case of intercostal nerve causalgia is presented which is the second reported case of causalgia not involving an extremity. This centripetal causalgia may be more common than is generally realized, and attention is brought to it to alert for this possibility.