The records of 729 cases of carcinoma within the terminal 25 cm of the large bowel were reviewed. Abdominoperineal resection, performed in 328 patients, most of whom had lesions within 6 cm of the anal verge, gave a crude five-year survival rate of 41%. The corrected survival rate, excluding Dukes' class D, was 69%. Anterior resection with end-to-end anastomosis, done in 197 patients for tumors from 6 to 25 cm, showed crude and corrected survival rates of 46% and 76% respectively. Anterior resection with side-to-end anastomosis, done in 204 patients for tumors in the same region, showed survival rates of 52% and 80%. Suture-line leaks occurred in 6% of the end-to-end group and resulted in two deaths from peritonitis. In the side-to-end group, suture-line leaks occurred in 3%, with no associated deaths.