Ulcerative colitis is a relatively common condition that is amenable to treatment and is often managed by outside specialist referral centers. The risks of acute toxic dilatation and the development of colonic carcinoma in patients with chronic disease have long been recognized. In recent years, the relative risk of developing either of these complications has been shown to be low compared with views previously held. The exact cause of death can be difficult to define in some cases. Patients may die of the disease itself, complications of medical therapy, or following surgical intervention. In this editorial, we have considered mortality from all causes in various centers where population-based studies have been conducted. Such deaths are relatively uncommon and occur with a frequency that ranges from 0.3 deaths per million per year in France to 16.4 deaths per million per year in Venezuela. The average figure seen in Scandinavia is about