Introduction: HTLV-I myelitis is a chronic disease, endemic in several countries, with well-established clinical and diagnostic criteria.

Methods: Etiology and immunology are reviewed based on 45 patients diagnosed and followed up in our neurology service since 1992. We evaluate the inclusion criteria , assessment scale (Osame`s motor disability scale) and blood, CSF, radiological (specially MRI) and neurophysiological studies for the diagnosis.

Results: Motor, sensory and long tract signs predominated. Patients resulted positive for HTLV1 by ELISA and Western Blot in blood and CSF. These results were similar as those previously reported.

Conclusions: We confirm the existence of chronic HTLV-1- associated myelitis in Ecuador, with an endemic focus in Esmeraldas region. It is necessary to perform new neuroepidemiological studies in order to obtain a better prevention and control of this disease in medical centers, blood banks and to monitor infected nursing mothers.