One hundred nine patients suffering blunt injury to the colon or rectum were treated between 1 January 1970 and 31 December 1980. Vehicular accidents accounted for 90% of the injuries and 91% of the fatalities. Multiple system injury predominated, with survivors averaging 1.9 and nonsurvivors 3.8 injuries/patient. Six cases were complicated by abdominal sepsis directly related to their colon injury. There were no deaths and no episodes of colonrelated abdominal sepsis among patients with isolated colon trauma. Of the 32 patients not surviving, four (3.7%), died as a direct result of their colon injury. Three of the four deaths appear to have been preventable.