Analgesic nephropathy is well recognised. This is a retrospective review of 19 patients with the disease, who presented at Groote Schuur Hospital over a 4-year period. The diagnosis was made on historical and clinical grounds and on the radiological manifestations of papillary necrosis. The mean age was 49 years (26 - 74) with a sex ratio of 3,8 female : 1 male. The period of abuse varied between 3 and 20 years. Aspirin, phenacetin, codeine, and antipyrine were the compounds mainly ingested. If the abuse is stopped, renal deterioration can be halted. However, factors which lead to dehydration and infection tend to cause further decompensation. As a means of preventing this disease greater control over analgescis is needed.