Since the discovery of the highly potent antifungal itraconazole (Sporanox®, Janssen Pharmaceutica) in the late 1970s, numerous patent applications and issued patents have appeared that describe and claim improvements for methods, manufacturing processes, formulations, enantiomers and uses for this commercially successful antifungal agent. In at least one case, the improvements have led to a new formulation product with proven clinical benefits. The patent history of itraconazole is reviewed herein.