6 chronic dialysis patients with acute mesenteric ischemia are described. 3 had nonocclusive infarctions, and 3 had occlusive disease. 5 of the patients had episodes of severe hypotension or hypovolemia immediately before the onset of abdominal symptoms. All patients had leukocyte counts of greater than 12,000 on admission, and 4 had stools positive for occult blood. The characteristic features of dialysis-induced hypotension followed by nonspecific abdominal symptoms and leukocytosis are emphasized.