The pathological data obtained from postmortem examination of the gastrointestinal tract in 78 chronic hemodialysis patients are reported. All but two of the patients exhibited some gastrointestinal abnormalities. Multiple abnormalities often coexisted in one individual. Esophagitis, gastritis, duodenitis, enteritis, and colitis were seen with considerable frequency. However, extensive hemorrhagic, ulcerative, and pseudomembranous lesions frequently seen in untreated uremia were generally lacking. Evidence of peptic ulcer disease was found in one-fourth of the patients confirming the increased predisposition of dialysis patients to this complication. Several patients exhibited various ischemic phenomena including thrombosis, embolism, and infarction of various segments of the gastrointestinal tract. In addition, numerous other abnormalities were found throughout the gastrointestinal tract with lesser frequency. The data indicate that various gastrointestinal abnormalities commonly occur in patients with endstage renal disease despite uremia control by hemodialysis. However, the observed abnormalities are different from those reported in untreated uremia.