One hundred twenty-three patients with lower chest and abdominal stab wounds were evaluated. If chest wounds were located between the two anterior axillary lines and abdominal examination was negative, peritoneal lavage was performed. If abdominal wounds were located between the two anterior axillary lines and physical examination was negative, local exploration was performed followed by lavage if local exploration was positive. Patients with negative lavage were observed and those with positive lavage were operated upon. Of the patients in this selected series 69.9% were spared an operative procedure. The incidence of negative laparotomy was 4.1%. It is concluded that the combination of local exploration and peritoneal lavage will increase diagnostic accuracy, eliminate unnecessary hospitalization, and reduce the number of negative laparotomies.