Following 15 major surgical procedures in 9 patients, epidural morphine was used for postoperative analgesia. The patients included a 9 yr old status-post (S/P) thoracotomy for bronchiectasis, a 4 yr old S/P thoracotomy for metastasis of a rhabdomyosarcoma, six adolescents S/P thoracotomy for metastasis of osteogenic sarcoma (OGS) and a 14 yr old with cystic fibrosis S/P abdominal surgery.The average dose of morphine was 0.12 ± 0.03 mg/kg of body weight (range: 0.06-0.18) or 0.03 ± 0.01 mg/cm of body height (range: 0.01-0.045). Mean duration of analgesia was 10.8 ± 4 hrs (range: 5-23). Catheters remained in place for 50 ± 16 hrs (range: 20-74). Quality of pain relief was judged to be excellent by the patients, parents and care providers. Following 10 of 74 epidural morphine injections mild pruritis occurred. Other side effects included nausea (3/74) and urinary retention requiring a catheter in 4 patients. No respiratory depression or hypotension was encountered.Improved quality of pain relief, improved pulmonary function and earlier ambulation are potential benefits of epidural narcotics. Children prone to respiratory difficulties or those likely to be subjected to multiple major surgeries may particularly benefit from epidural narcotics postoperatively. In conclusion, epidural morphine can provide reliable postoperative pain relief in children and adolescents.