A variety of small-bowel malignant neoplasms have been reported in association with nontropical sprue (celiac disease). Lymphomas have been the most common malignant neoplasms to complicate this disease. However, adenocarcinoma of the small bowel has infrequently been reported. The suggestion has been made that patients with nontropical sprue are at increased risk for developing small-bowel adenocarcinoma. Three additional cases of small-bowel adenocarcinoma in association with nontropical sprue are reported.