The management of the alcoholic withdrawal syndrome in the intensive care unit is difficult. Clearly, the patient must be sedated, in order to avoid the side-effects of agitation, like trauma. However, a too much enthusiastic sedation has to be avoided, first because it may unmask neurologic important information, and, second, because it can prolong or complicate the ICU stay. In this review, we discuss the actual management of the alcoholic withdrawal syndrome in the ICU.