We studied and followed up 112 African patients with Kaposi's sarcoma for at least 3 years or until death to determine what features of the disease at presentation most accurately predicted the prognosis. The clinical pattern of disease at presentation was most important. All patients with generalized disease died of their disease; the only deaths among those with nodular disease were due to intercurrent illness. The 3-year survuval rate among patients with locally aggressive lesions with 64%. We could obtain greater refinement of prognosis by noting the response to a dinitrochlorobenzene challenge, the presence of nodal involvement, and the histologic pattern of the tumor. The age and sex of the patient influenced the pattern of disease likely to be found, but the prognosis for a given clinical pattern was the same in both sexes and at different ages.