A group of 46 patients, 4 to 74 years old, scheduled for laser treatment of port-wine stains were included in a multicentre double-blind study designed to assess the analgesic effect of EMLA cream. Patients were randomly allocated to receive EMLA (n= 23) or placebo cream (n= 23) applied a minimum of 1 h before treatment. Pain was assessed on a 10-cm visual analogue scale (VAS). Of the 46 patients, 41 were available for efficacy analysis. The difference in VAS scores was found to be statistically significant in favour of EMLA compared with placebo. The median VAS scores were 2.4 and 4.8 for EMLA and placebo patients, respectively. Pain scores according to age (adult/child), localization of angioma (head and neck/other), type of laser (argon, YAG, pulsed and continuous dye laser), and cream application time (>or 90 min) were lower with EMLA. Transient local skin reactions were observed with both formulations with equal frequency. It is concluded that EMLA reduces pain in laser treatment of port-wine stains after a minimum application time of 1 h.