The findings in 58 patients with acute viral (42) or drug (16) hepatitis who underwent laparotomy were reviewed to determine the effects of operation on mortality and morbidity in acute hepatitis and the reasons why operation had been advised. In most cases, operation had been advised because of suspected extrahepatic biliary obstruction. Four patients with viral hepatitis died; nonfatal major complications occurred in five others. No deaths or serious complications occurred in patients with drug hepatitis. Misleading factors that contribute to an erroneous diagnosis are emphasized.