Low pH in tissue can evoke pain in animals and humans, and is an important factor in hyperalgesia. Research has also implicated acidosis in psychiatric and neurological diseases. One emerging class of pH-detecting receptors is that of the acid-sensing ion channels (ASICs). Advances in ASIC research have improved the understanding of the role played by pH dynamics in physiological and pathophysiological processes. Increasing evidence suggests that targeting ASICs with pharmacological agents may offer an effective and novel approach for treating pain and diseases of the CNS. However, the development of pharmaceuticals that target ASICs and are suitable for clinical use remains an obstacle. This review provides an update on ASICs and their potential for therapeutic modification in pain and CNS diseases.