Continuous Spinal anesthesia (CSA) as a technique evolved since Augustus Bier described the first Spinal anesthetic with Cocaine in 1899, and in 1906 Henry Percy Dean invented the "exploring needle" which can be left in situ during the operation so that at any moment another dose can be injected. CSA has marked advantages in certain clinical circumstances, particularly patients undergoing lower body surgery who are old and/or have co-morbidities, they can benefit from avoiding the risks of endotracheal intubation and general anesthesia and in the same time avoiding rough hemodynamic changes associated with other types of neuraxial blocks without losing their advantages. Also the intrathecal catheter can be used for post-operative analgesia and for long term intrathecal drug administration to control chronic pain or spasticity. There are many types of intrathecal catheters that can be used with different techniques of insertion, advantages and disadvanatages. Also there are possible complications to the technique which must be understood and managed, and contraindications with which the technique should be avoided or modified.