The morbidity of total gastrectomy and the effect of operation on body weight and nutrition were studied in a series of 20 cases and are reported with a review of the literature. The morbidity of the operation, as judged by fitness, symptoms, and work capability is high, especially in malignant cases. Prominent symptoms are absence of hunger, reflux and limited capacity for food. Time is important in evaluating the effect of operation on weight. About 40 per cent always maintain normal weight and 17 per cent are always subnormal: the weight of the remainder varies with time. Dietary intakes after total gastrectomy are usually poor not only in respect of calories but in regard to protein, minerals and vitamins.