The operation of exenteration of all pelvic viscera with urinary and fecal diversion has been under critical evaluation for the past several years. Since July, 1947, a total of 118 such operations have been performed by us in St. Louis for various lesions (Table 1). Previous publications* have included patients operated upon at the Ellis Fischel State Cancer Hospital at Columbia, Mo., by Dr. John Modlin and Dr. Henry Schwarz. This study does not include these patients. Following the lead of Brunschwig and others,† advanced carcinoma of the cervix and other lesions of the female genital tract were added to the study in April, 1950. It is the purpose of this report to add our own current evaluation of this procedure to those appearing in the literature in recent years.‡ The operation has been described previously § and is performed in the same manner at the present time. The essential