Primary tumors of the small bowel are relatively uncommon. The discovery at autopsy of small bowel malignancies is between 0.05% to 0.5%.1 Only 24 small bowel tumors were found during 17,070 autopsies done at the Massachusetts General Hospital during a 43-year period.2 We are reporting 41 consecutive cases of primary malignant tumors of the small bowel seen at the General Surgical Service of the University of Kansas Medical Center during the past 20 years. Only the cases which were confirmed on operative histopathology or autopsy findings are included. All other tumors in which there was doubt of origin or metastases to the small bowel are excluded. Tumors arising from the head of the pancreas, ampulla of Vater, or appendix are also excluded from this study. Methods Age and Sex Incidence.—There were 25 males and 16 females (a ratio of 1.5:1.0). The youngest patient was 4 years old