The treatment of ulcerative colitis is primarily a medical problem and fortunately most patients with this disease respond reasonably well to a carefully regulated medical management. In some patients these conservative measures are insufficient to control or arrest the disease, and surgical treatment is indicated and necessary for relief. As the result of recent interest and study of ulcerative colitis there have been many reports dealing with the etiology, diagnosis and medical management of these cases, so that at present the disease is suspected earlier in its course and its presence is proved by proctoscopic examination and the barium enema. There have been fewer reports dealing with the surgical treatment of the intractable cases. It is my purpose in this discussion to present a group of these patients treated at the Lahey Clinic by ileostomy and by partial and complete colectomy and to outline indications for operation and the results