Practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. The implementation of practice guidelines is justified by factors such as variations in clinical practice, malpractice and its associated costs, and the need to contain health care expenditures. In this context, practice guidelines promote a more rational approach to clinical decision making and better quality of care. Although there are several limitations to the use of guidelines in current practice, different organizations (professional societies, government agencies, licensing authorities, educational institutions) have a potential interest in their development. A working group on the development of practice guidelines endorsed by the Italian Society of Neurology has been active since 1995. The aims of this group include the development of guidelines to be accepted by the medical community and to be placed within the framework of initiatives of the Italian Ministry of Health.