As a response to widespread structural or endemic human rights violations, in 2004 the European Court began to issue pilot judgments, the aim of which was not only to exert further pressure on national authorities to tackle systemic problems, but also to stop the European Court itself being inundated with the same types of cases. Fashioned out of its own case law, and underpinned by the principle of subsidiarity, the Court has broken new ground with its pilot judgment procedure, both in terms of its diagnosis of the causes of systemic human rights violations, and the extent to which it is prepared to direct states to legislate, or take other steps, to resolve them. This study (supported by the Leverhulme Trust) analyses the principal characteristics of the pilot judgment procedure and its application in key cases to date. With case studies on Poland, Slovenia and Italy, a particular focus of the work is the adequacy of the response of national authorities to pilot judgments. It draws conclusions about the effectiveness of the procedure as a means of tackling systemic violations, and makes recommendations for its further development.