The results of surgical treatment of 301 patients with malignant tumors of the colon and rectum presenting to two small district general hospitals in the years 1972 to 1977 were analyzed. Two hundred seventy-four patients (91 per cent) underwent surgery with an operative mortality of 8.7 per cent. Curative resections were performed in 58 per cent of the patients. The overall crude five-year survival rate was 32 per cent. The crude five-year survival rates for curative resection, palliative procedures, and inoperable patients were 47 per cent, 11 per cent, and 0 per cent, respectively. Survival rates were considerably improved in patients in the 40-to-50-year age group with 9 to 12 months' duration of symptoms, and in those with early unfixed, resected tumors. It was diminished in patients with bowel perforation presenting as an emergency, and in patients with two weeks or less duration of symptoms. Survival was not related to the site or grade of the tumor.