Cauda equina syndrome is a devastating condition often following an innocent pathology in the form of a disc prolapse. The effect on sufferers, however, can be lifelong. It is necessary to make a diagnosis as expeditiously as possible via adequate history, clinical examination and appropriate imaging to offer treatment, in the form of decompressive surgery within 48 hours. It is extremely important to communicate adequately with the patient and their family recording all the relevant details including those of expected outcome. National guidelines are likely to be of value to clinicians and patients. [ABSTRACT FROM AUTHOR]