Strictures of the rectum may be congenital or acquired. Acquired strictures of the rectum result from scar tissue arising from trauma, infection or narrowing of the bowel from a new growth. The lesion causing the stricture may be in the bowel wall itself or may constrict the lumen of the bowel by pressure from without. Excluding the usual adenocarcinomas of the rectum and many venereal strictures of the rectum seen in consultation in the Cook County Hospital, we have the record of 104 patients in whom stricture of the rectum was found. The great majority of these patients have been under observation during the last ten years. The accompanying table shows the causative factors involved. CONGENITAL STRICTURE OF THE RECTUM Congenital stricture of the rectum is not common but is occasionally seen as the result of failure of the proper union of the infolding skin and the descending bowel in