This paper describes the clinical management of 204 patients with Crohn's disease involving the colon who have been reviewed regularly for many years. The results have been analyzed to define the morbidity, mortality, and long term prognosis of the disorder. Despite a high morbidity, the long term prognosis is good. Although the mean interval since the onset of symptoms is more than 13 years, 77% of the patients are symptom-free and 60% have normal laboratory indices. This analysis suggests that until the etiology of Crohn's disease is established and a specific therapy is developed, good results can be obtained with regular medical review and appropriate surgical treatment with the limited use of immunosuppressive agents or total parenteral nutrition.