Although a number of treatments have been reported to be effective with yellow nail syndrome (YNS), vitamin E at high doses is the only one that has been successfully utilized in a consistent number of patients affected by YNS. Recent data indicate that itraconazole pulse regimen may be effective in this disease. We report our experience with itraconazole treatment in patients affected by YNS. Systemic itraconazole was administered in eight patients (five males and three females; mean age 55.2 years), at a dosage of 400 mg daily for 1 week a month for 6 months. Nail growth was measured every 3 months. Complete cure was achieved in two of eight patients, with mild improvement in two and no improvement in four. The results of our study show that itraconazole cannot be considered effective for YNS, especially if compared with vitamin E, the efficacy and tolerability of which is already proven.