In a retrospective study I assessed operative mortality in patients with biopsy-proven chronic hepatitis. Most patients had no symptoms from their liver disease. All patients were considered to have a viral cause of their chronic hepatitis--five were hepatitis-B surface antigen positive. Seven patients had chronic persistent hepatitis, and 13 had chronic active hepatitis (including four with cirrhosis). Twenty patients underwent 34 operative procedures, including 28 general endotracheal anesthesia and six spinal anesthesia. Although two patients who had preoperative bilirubin levels of 2.5 mg/dl or greater sustained further increases in serum bilirubin postoperatively, the serum liver chemistries of the entire group did not significantly worsen postoperatively. There was no anesthesia-related liver failure or operative mortality. Patients with asymptomatic chronic hepatitis tolerate surgical procedures well.