The lateral cutaneous nerve of the thigh (LCNT) supplies a large area of skin in an ideal site for harvesting a split skin graft. LCNT block was used as primary local anaesthesia for harvesting split skin grafts in 23 patients with a variety of injuries. Their ages ranged from 26 to 99 years. The mean age was 69 years. The onset of full anaesthesia took between 15 and 20 min. The area anaesthetised ranged from 250 cm2 to 1020 cm2 with a mean of 569 cm2. There were 17 successful blocks and 6 failures. Most of the 6 failures occurred during the early phase of the study. We have found that, with experience, LCNT block is a safe, simple and reliable method for achieving adequate anaesthesia for harvesting split skin graft from the thigh and that it provided excellent postoperative analgesia.