The management of 54 acromegalics was analyzed. Twenty-two patients were treated with pituitary implants of 90Y. Eleven are in complete remission (mean growth hormone (GH) < 11 mIU/l), 8 had improved (mean GH 11-20 mIU/l or 50% less than preoperatively) and 3 were poor responders. Two patients had temporary 6th nerve paresis. Seven patients are on replacement therapy. Thirty-one patients were not implanted for the following reasons with a number of patients having more than one: extension of the tumor into the sphenoid sinus 10, or above the sella 3, partially empty sella 9, internal carotids too close to midline 2, invisible landmarks 1, mild acromegaly 6, poor general health 3, declined investigations or operation 6. Pituitary Y implant is evidently an effective and safe form of treatment in carefully selected patients.