OBJECTIVE.: To evaluate the influence of intrapartum epidural analgesia on the occurrence of ST events of the fetal ECG. DESIGN.: Nested case–control study. SETTING.: Single-centre academic hospital in the Netherlands. POPULATION.: Laboring women with a high-risk singleton pregnancy in cephalic position beyond 36weeks of gestation. METHODS.: Data of 72 women who received epidural analgesia using bupivacaine combined with sufentanil and 72 control women were collected and analyzed. The moment of epidural infusion was defined as t0. In the control group, t0 was defined by matching dilatation in centimeters. STAN® registrations from one hour before until two hours after t0 were classified, and the numbers and types of ST events were recorded and judged according to the STAN® clinical guidelines. T/QRS ratios were collected from one hour before t0 until two hours after t0, and differences were compared between the two groups. MAIN OUTCOME MEASURES.: Numbers and types of ST events and mean T/QRS ratios before and after t0. RESULTS.: There were no significant differences between cases and control women regarding the numbers of ST events, types of ST events and whether they were significant (intervention advised) or not. Correction for outliers (three cases and three control women) did not change the results. Differences of T/QRS ratios before and after t0 were comparable between cases and control women. CONCLUSIONS.: Epidural analgesia has no effect on the numbers or types of ST events when using ST analysis of the fetal ECG.