Cryptococcal meningitis is a difficult disease to treat and requires biochemical and haematological monitoring to detect the common adverse effects of treatment. Combination therapy with amphotericin B and flucytosine for at least 6 weeks is the best treatment so far evaluated. The role of azole drugs should become clearer as the results of large multicentre studies become available in the future. High case fatality and morbidity rates despite standard treatment suggest that other ancillary treatments such as corticosteroids and other treatments directed at lowering raised intracranial pressure may also be required in some patients.