Enterostomal therapy (ET) is an allied health specialty that began in 1958. Currently there are 198 certified therapists in uneven geographic distribution throughout the nation. There are five training centers, none of which is west of the Mississippi River. A clear trend toward the development of ET as a nursing specialty is evident, and there are signs suggesting that hospital-based, physician-supervised programs are growing in preference to independently practicing therapists. The valuable and loyal support and services of volunteer patient groups are essential to effective hospital-based ET programs. The development of an ET program in a 700-bed university teaching hospital has been described and a projection into the future has been made.