In order to get pyinotify working on CentOS 5 x64 a few workarounds need to take place.

(Thanks to Matthew Ife at ukFast for help with this)

First off you are going to need the python-ctypes RPM, available from DAG here: python-ctypes-1.0.0-2.el5.rf.x86_64.rpm

Once installed you are going to need the Fedora 8 python-inotify SOURCE rpm available from here: python-inotify-0.8.0-3.r.fc8.src.rpm

The easiest way I found to extract the required packages was using the following:

mkdir ./python-inotify
cd ./python-inotify
wget ftp://ftp.pbone.net/mirror/archive.fedoraproject.org/fedora/linux/updates/8/SRPMS.newkey/python-inotify-0.8.0-3.r.fc8.src.rpm
rpm2cpio ./python-inotify-0.8.0-3.r.fc8.src.rpm | cpio -idv
tar -zxvf ./pyinotify-0.8.0r.tar.gz
cd ./pyinotify
./setup.py install