Porphyria cutanea tarda is often associated with hypersiderosis. Weekly or biweekly phlebotomy of 500 ml of blood depletes iron stores by mobilizing iron for hemoglobin formation to augment erythropoiesis. Uroporphyrin and coproporphyrin values were reduced to normal or near normal with regression of skin lesions and loss of cutaneous fragility. Remission has persisted up to 18 months. With phlebotomy serum iron and copper values were reduced and serum zinc and magnesium levels remained unchanged. Deferoxamine mesylate did not cause sufficient urinary iron excretion to justify its therapeutic use.