125 patients with ulcerative colitis, considered to represent the unselected population of patients with this disease from a defined catchment area during the years from 1961 to 1983, were studied. The mortality from colitis was 5%, with no peroperative death after 1978. No prophylactic proctocolectomy was performed and there were no deaths in colorectal cancer. The cumulative operation frequency was 26%, and 37% in the subgroup of patients with total colitis. During the first 5 years of disease the operation frequency was 14%. It is concluded that, in a unselected population of patients with ulcerative colitis, satisfying results can be obtained at a community hospital, providing the surgical attitude to severe acute and disabling chronic disease is aggressive.