Superior vena cava obstruction (SVCO) is most commonly due to malignant or thrombotic causes. The traditional treatments of surgery, radiotherapy or chemotherapy either have a high morbidity and mortality rate, or a lag period of a few weeks prior to response. Superior vena cava stenting is able to provide rapid relief of symptoms safely in the vast majority of patients. It has now become the first-line treatment for malignant SVCO, and is increasingly being used in benign SVCO. The complication and success rates compare very favourably with the other treatment modalities.