An overview of computer models developed since the late seventies, which enable the simulation of the primary e ects of spinal cord stimulation (SCS) on nerve ®bres, is presented. These models consist of a 3-dimensional volume conductor model, representing anatomical structures and their electrical conductivities, and cable models representing the electrical behaviour of nerve ®bres. The characteristics of these models and their relation to anatomy and physiology, as well as the calculation of stimulation-induced electrical ®elds and their e ect on nerve ®bre models, are reviewed. It is shown that most characteristics of SCS as predicted by computer modelling correspond well with empirical data. Accordingly, a theoretical framework describing the relations between relevant parameters in SCS is presented. Finally, it is shown how theory and computer modeling are applied to improve the e cacy of SCS by the optimization of its technique, primarily by the design of new epidural electrodes.