Despite the great advances and refinements of technique in radiation therapy, the treatment of gynecological cancer by irradiation remains a two-edged sword. Roentgen dosage sufficient to eradicate the malignancy carries the hazard of injury to normal tissue. This damage is usually minimal and resolves promptly, but it may be so extensive that, despite cure of the malignancy, prolonged morbidity and even mortality may result. Intestinal complications of radiation therapy can be extremely vexing problems for both patient and physician. The general surgeon is frequently called to see these patients at a time of crisis; unless he is familiar with the pitfalls involved, errors are likely to occur which can further complicate the course and outcome of this iatrogenic disease. Our recent experience with two fatal cases and several others that came to surgery has prompted us to review our own experience and some of the literature pertinent to the subject.