This study reviewed retrospectively the records of eight patients treated surgically for adenocarcinoma of the duodenum, a rare lesion. The lesion characteristically produced weight loss, obstructive symptoms, occult or overt gastrointestinal tract bleeding, and, if periampullary, jaundice. Results of the upper gastrointestinal tract barium examination pointed to the lesions in six of the patients. Three of four patients are alive 14 months to seven years after pancreaticoduodenectomy; one of two survives five years after duodenal segmental resection. Bypass procedures in two patients were followed by the only hospital death in the series, in one, and eight months survival in the other. This small study, while not conclusive, supports the concept of an aggressive approach to duodenal adenocarcinoma by pancreaticoduodenectomy.