Blockade of the superior hypogastric nerve plexus was performed for relief of chronic cancer related pelvic pain. The targeted sympathetic nerves lie anterior to the sacral promontory. Twenty-eight patients with neoplastic involvement of pelvic viscera secondary to cervical, prostate, and testicular cancer or radiation injury were treated with neurolytic superior hypogastric plexus block. Sympathetically mediated pain was significantly reduced or eliminated in all cases and no serious complications occurred. Superior hypogastric plexus block is recommended for diagnostic/prognostic and therapeutic purposes in patients with chronic pelvic pain, particularly when pain is of neoplastic origin.