The authors assessed the usefulness of color Doppler imaging in the monitoring of vascular circulation after free jejunum transplantation. Seven male patients were examined daily with color Doppler sonography for the first postoperative week between 1999 and 2000. All sonographic examinations were performed with an SSD5500 ultrasound scanner. Arterial and venous signals were documented reliably in all patients. The flashing red spots around the serosal wall revealed the patency of the anastomosed artery and vein. No failures of the graft occurred. The presence of the color Doppler signals was considered sufficient to define vascular patency. The real-time monographic (B-mode) examination revealed the thickness and the plicae circulares of the jejunum wall. These monographic (B-mode) images supported the viability of the transplanted jejuna. The authors found color Doppler sonography to be a reliable and effective form of monitoring after free jejunum transplantation.