There is disagreement between authorities on most facets of trichinellosis therapy. The most controversial issues are when to use corticosteroids and which antihelminthic drug should be administered, for how long and at what dose. These issues are particularly important in the treatment of severe, potentially fatal infections. A major reason for the lack of consensus regarding trichinellosis management is that there have been very few prospective, controlled clinical trials of this infection. After a brief review of pertinent epidemiological and clinical features of the disease, selected treatment concerns will be discussed and areas where more information is urgently required will be highlighted.