The records of 50 consecutive cases of Hirschsprung's disease treated at the University of Michigan Hospital showed an overall mortality of 16%. Three quarters of these deaths were related to complications resulting from delayed diagnosis. Enterocolitis was recorded in one quarter of the patients and accounted for half of the deaths. Diagnostic measures other than rectal biopsy were unreliable. Right transverse colostomy is preferred for fecal diversion. Grob's modification of the Duhamel procedure is the current choice for the definitive pull-through procedure.