Outcome was reviewed for 180 stage I and II pts with follicular small cleaved cell (fsc; n = 103 [57%]) or follicular mixed small cleaved and large cell lymphoma (fmx; n = 77 [43%]), treated at Stanford 1961–1994. Pts received 35–50 Gy to one side of the diaphragm (involved or extended fields) or both sides of the diaphragm (total or subtotal 1ymphoid XRT). There were 74 (41%) stage I and 106 (59%) stage II pts. M/F ratio was 1.2. Median age was 53 yrs. Staging laparotomy (lap) was performed in 45 pts (25%) and 34 (19%) had extranodal lesions. Median follow-up (f/u) was 7.7 yrs; longest f/u was 31 yrs. Actuarial survivals at 5, 10, 15 and 20 yrs were 82%, 63%, 43% and 35% respectively. Actuarial freedom from relapse (FFR) was 55%, 44%, 43% and 35% respectively, at the same intervals. Median survival after relapse was 5 yrs. Only 5 of 47 pts at risk for more than 10 yrs after XRT have relapsed (latest relapse 21 yrs post XRT). Survival was worse for pts aged >40 yrs (P = 0.053) and worse still for pts aged >60 (P = 0.0001). FFR was also worse for pts aged >60 (P = 0.019). Multivariate analysis of prognostic factors indicated that youth and staging lap were most strongly associated with long survival and that treatment on both sides of the diaphragm and staging lap were most strongly associated with prolonged FFR. These data suggest that XRT alone is potentially curative for early-stage low-grade follicular lymphoma. Although >50% will relapse within 10 yrs, only 10% of pts at risk may relapse later. Early relapses may be related to “under-staging” because lap-staged pts have superior FFR.