Ketamine was developed in 1962 and has received wide international recognition for its excellent properties as a fast-acting anesthetic. Several decades later, emergence of new intravenous and inhalation anesthetics, as well as powerful short-acting synthetic opioid analgesics led to a noticeable decrease in consumption in ketamine in the developed countries. Active research of NMDA receptor blockade (glutamate N-methyl D-aspartate calcium channel) in the late 20^th century years established that ketamine is its non-competitive direct-acting antagonist. These data changed a paradigm in the treatment of perioperative and other categories of pain and returned ketamine as «antihyperalgesic» drug. Today, ketamine is still interesting. After more than 50 years, ketamine is returning to clinical practice in the economically developed countries. In this manuscript, the authors summarize international and domestic experience of the use of ketamine in chronological aspect and present modern indications for ketamine in acute pain management.