CARCINOMA of the rectum and rectosigmoid is still a controversial subject in medical literature, and because of this we are presenting herein a study of one hundred and thirty-seven consecutive combined abdominoperineal resections of the rectum performed in the Cleveland Clinic Hospital from Oct. 20, 1941 to June 24, 1943 without operative mortality. We feel that this paper will contribute to the growing weight of evidence in favor of the one stage combined abdominoperineal resection as contrasted with operations of lesser magnitude. (One patient died of suppression of urine.) The technic in all cases was identical, namely, the performance of the Miles operation, with a few modifications for the operator's convenience. Spinal anesthesia with "metycaine hydrochloride" was used in every case. All wounds were closed primarily with alloy steel wire sutures. No sulfonamide drugs or antibiotics were used in the preparation of the patients or at the time of operation.