We report the effective use of epidural block in three patients with ‘painful legs and moving toes’ syndrome, which is characterized by involuntary movements of the toe (and sometimes of the foot) and excruciating pain in the leg. Several treatments had been unsuccessful in the management of the three patients reported including baclofen, benzodiazepines, carbamazepine and antidepressants. In two patients, lumbar sympathetic block was performed, the symptoms being alleviated temporarily in one patient. In contrast, injections of mepivacaine into epidural space suppressed pain and movements in all patients. In one patient, symptoms disappeared for many years after several epidural blocks. In the remaining two patients, epidural injections were repeated when the symptoms were severe.