Summary In summary, five fatalities due to anastomotic complications were encountered in a series of 153 anastomoses, with a resulting mortality incidence of 3 per cent; the incidence of all types of anastomotic complications was 8.6 per cent. The latter group included a considerable proportion of defects which were asymptomatic and found incidentally in post-operative barium studies. Unfortunately these figures cannot be compared statistically with other series because of the diversity of the series' population. Review of the operative circumstances preceding each of the anastomotic failures leads to the conclusion that the method of anastomosis, as long as it is done well, is not nearly as important as the conditions under which it is done, and accordingly, the anastomotic mortality rate in distal colonic resections is primarily dependent upon the surgeon's acceptance of a proximal colostomy when fistulization, appreciable partial obstruction or active infection is present at the time of surgery. The occurrence of anastomotic obstructionin but two cases, symptomatic stenosis in none, and symptomatic anastomotic leaks in only two cases without pre-existing complications tends to affirm our confidence in this technic of anastomosis, the principal advantage of which is simplicity.