Chemical neurolysis of the celiac plexus is a valuable tool in management of intraabdominal cancer pain. Repeat neurolytic blocks are sometimes required for adequate pain control. We report a case of percutaneous celiac plexus neurolysis following inadequate intraoperative neurolytic blockade. Success rates and possible reasons for failure of the percutaneous and open intraoperative approaches are discussed. Advantages and risks of each approach are considered.