Over an 8-year period, 106 patients with cancer who were major operative risks received intravenous hyperalimentation (IVH). All were malnourished, had gastrointestinal obstruction or had postoperative complications such as fistulas, evisceration or intra-abdominal sepsis, which left IVH as the only means of achieving anabolism. When IVH was started preoperatively and continued postoperatively (34 patients), no deaths or major complications occurred. When IVH was first started after serious complications had occurred (62 patients), the incidence of recovery was high; the mortality was 17.7%. When IVH was given to cachectic patients whose cancer was inoperable to enable them to tolerate radiotherapy or chemotherapy (10 patients), the mortality was 40.0%. Although this last group is small, IVH is worthwhile in selected patients in whom good palliation life can be obtained. With careful IVH and improvement in the quality of technique, the risk of sepsis was no greater than in patients without cancer.