The authors reviewed the records of patients with myasthenia gravis who took cyclosporine for at least 6 months between November 1987 and January 1999. Of 57 patients who took cyclosporine for an average of 3.5 years, 55 (96%) had clinical improvement. The median time to best clinical response was 7 months. Corticosteroids were discontinued or decreased in 95% of 38 patients taking them. Major side effects included elevated serum creatinine (28%) and malignancy (11%). Five percent could not afford or tolerate the drug.