On premise help desk support ticket software

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What do you recommend for a help desk, on premise install, support ticket type software for a medium sized business?  
(For Windows based network and computers)
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Most Valuable Expert 2012
Top Expert 2014

Commented:
We use Spiceworks. While not perfect, depending on requirements, it is free.

Rob.
You should tell how many users and how many tickets per month instead of "mid size business".

We are using Trac on Windows (https://trac.edgewall.org/) for about 50 users and around 500 tickets per month. The performance is better on Linux but the new version 1.4 seems to be fast enough even on Windows.
kevinhsiehNetwork Engineer

Commented:
We use SolarWinds. Pretty happy with it. Multiple work flows.
Infotrakker Software
Most Valuable Expert 2012
Top Expert 2014
Commented:
There's also YouTrack, which is free for up to 3 users (cloud) or 10 users (standalone):

https://www.jetbrains.com/youtrack/
Darren CollinsTech Lead (Windows), Endpoint Device Management Services

Commented:
I would not recommend an on-premise solution.  There are many that are we-based applications / software-as-a-service solutions, which are far less problematic and have a much lower overall TCO.

Personally I would not recommend Ivanti Service Manager though, as we use it and I think the UX is terrible and encourages technical support teams to avoid it.

I have heard great things about ServiceNow's ITSM offerings, but I have no personal experience (or affiliation by the way!) - https://www.servicenow.com/products/itsm.html

Good luck,
Daz.

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