Although poliomyelitis continues to be the major crippling disease of children globally, protocols for its management have not been significantly updated since the disease was eradicated in the industrialised world in the early 1960s. An understanding of the pathophysiology of poliomyelitis and its late sequelae (part 1), in conjunction with contemporary principles of rehabilitation practice, provides a basis for revising the principles of acute management of this disease. A detailed multisystem assessment is the basis for the treatment prescription. This assessment includes evaluation of the child's growth and development and nutritional status, given that the majority of children who contract poliomyelitis live in developing countries where malnutrition is prevalent. Finally, we provide some guidelines for developing a poliomyelitis clinic based on minimal resources. Sociocultural factors must be considered and integrated into programme planning, however, because the success of the programme will rest, in large part, on the sensitivity of the facility and its staff to such factors.