Though chloroprocaine was initially described as a spinal anesthetic, it has fallen into disfavor in the past two decades because of concerns about neurotoxicity. This notion has recently been challenged by a series of studies. The future of 2-chloroprocaine as a medication for intrathecal use is currently in flux, and further studies are underway to further define its use. It was initially shown that 2-chloroprocaine was an appropriate substitute for intrathecal lidocaine, providing similar quality, height, and duration of block when compared to equal doses of lidocaine. A later study showed that 30, 45, and 60 mg of 2-chloroprocaine yielded mean maximal block heights of T7, T5, and T2 and block duration of 98, 116, and 132 minutes, respectively. When 20 mcg of fentanyl was added, the duration of sensory but not motor blockade was lengthened (by 25 minutes). When epinephrine was added to 2-chloroprocaine, a transient flulike syndrome was reported, leading to the recommendation to avoid this combination. When compared to other local anesthetics for ambulatory surgery, 2-chloroprocaine provides adequate duration and quality of blockade, with significantly faster resolution than bupivacaine and less risk of transient neurological syndrome (TNS) than lidocaine. Considerable controversy still surrounds the issue of potential neurotoxicity of spinal 2-chloroprocaine. The prevailing conclusion of a series of animal studies was that the preservative sodium bisulfite, possibly in combination with low pH, was responsible for several early episodes of irreversible blockade. However, at least one study suggests that 2-chloroprocaine may itself be neurotoxic, and that sodium bisulfite may actually be neuroprotective.