Background-The evidence for clonidine as an analgesic for cancer and non-cancer pain via the intravenous, intrathecal and epidural route is strong but systemic administration via the oral route is weak. Aims: The primary aim was to examine the effectiveness of oral clonidine as an analgesic in patients with complex cancer and non-cancer pain needs. The secondary aims include finding the median range in dosing and dosing intervals in patients where clonidine has been well tolerated, and establishing what side effects are experienced by these patients. Results-Twenty-one patients who were commenced on clonidine were identified. Thirteen patients were men and eight were women.  Average age was 51.77 years old. Mean duration of the patient’s pain was 74.45 days and median duration was 37.5 days. Average starting dose of clonidine per day administered was 83.5 micrograms per day, while the maximum total daily dose was 103.4micrograms. Of the patients, 14 had cancer related pain and the remaining non cancer related pain.  The most common site of pain were the legs. The average pain score prior to starting clonidine was 7.59 and the average pain score after starting clonidine was 5.59. Majority (15) patients demonstrated a decrease in their use of “as required analgesia” after clonidine introduction. Of the 22 patients included in the study, majority (15) patients demonstrated a decrease in their use of “as required analgesia” after clonidine introduction. Conclusion: The current study demonstrates that oral clonidine is an effective co- analgesic in resistant cancer and non-cancer pain, including in the treatment of OIH. Systemic side effects are uncommon when oral clonidine was used at dosages up-to 200mcg/day in divided doses. We would recommend more research into the use of clonidine as a co-analgesic in difficult to control pain.