Septic thrombophlebitis of the large veins of the neck is an uncommon, but extremely severe, complication in carriers of central venous catheters. Treatment of these cases is difficult and, generally, the clinical condition does not permit surgical approach. Four patients with septic central vein thrombophlebitis are reported. They were treated with conservative measures including catheter removal and high-dose parenteral antibiotics for at least four weeks, with excellent results in all. The relevant literature and the therapeutic alternatives are reviewed.