The specific pathway of "pure", histaminergic, itch is traced from the mechanoinsensitive nerve fibers in the skin to their central cortical projections. Neuropathic itch created at different levels of this anatomical pathway is reviewed. In this review we discuss damage to pruritoceptors in the skin, entrapment syndromes, damage to spinal ganglia, nerve root impingement, injury of the spinal cord and cerebral damage in the distribution of the middle cerebral artery, capsula interna or thalamus. Itch in inflamed skin resulting from interactions between nerve transmitters and other mediators of inflammation is described.