Introduction Polycythemia vera was first described by Vaquez in 1892.1 Osler, in 1903, collected 6 cases and proposed that this syndrome constituted a new clinical entity.2 At the present time polycythemia vera is usually classified as one of the myeloproliferative syndromes,3,4 because apparent transformations among polycythemia vera, acute leukemia, chronic myelocytic leukemia, myelofibrosis, and Digulielmo's syndrome have been observed; however, the cause of all these syndromes remains obscure. Polycythemia vera has been the subject of some excellent reviews.5-7 The purpose of this paper is to review the clinical course, complications, and prognosis of polycythemia vera as exemplified by a group of 50 patients, with particular reference to the problem of surgical risk in this disorder. Materials and Methods The records of 50 patients with polycythemia vera seen at the University of Virginia Hospital between the years of 1940 and 1958 have been reviewed. Information about these patients has been obtained