SummaryAlthough management of chronic ulcerative colitis continues to challenge the physician, our ability to treat this devastating disease is rapidly improving. Experience at the Ochsner Clinic indicates that the incidence and clinical picture of this condition are similar to those reported from medical centers located further North. Results of medical treatment are usually satisfactory, although the disease still exhibits a pronounced tendency to relapse. The most satisfactory surgical method of handling intractable chronic or fulminant ulcerative colitis or dangerous complications is total or subtotal colectomy and ileostomy.