Thoracic outlet syndrome (TOS) is one of the most controversial subjects in clinical medicine. In spite of the increasing skepticism voiced in the medical literature, many patients continue to he diagnosed as having TOS and treated surgically. Colorado is one of the leading states where TOS surgery is performed. We have examined the 1989 data as collected by the Colorado Hospital Association and have defined a patient profile and reimbursement pattern. Of the 174 patients who underwent surgery, women outnumbered men by three to one (132 to 47), even when worker's compensation was the payer. The data show that patients who do not have private insurance or worker's compensation are rarely diagnosed as having TOS. Medicaid patients almost never undergo surgery.