One hundred and eight patients with a diagnosis of malignant mixed müllerian tumors of the uterus treated at the M.D. Anderson Hospital from 1948 through 1977 were analyzed. Pathology was reviewed and subdivided according to the sarcomatous element. No difference in pattern of recurrence or survival could be demonstrated between homologous, heterologous, or undifferentiated sarcomatous elements. Nine patients were treated with only palliative intent due to advanced local disease combined with poor medical condition. Of the remaining 99 patients, 87% had minimum surgical procedures of total abdominal hysterectomy. All but two of these patients had adjunctive radiation either preoperatively or postoperatively. The 5-year survival rate was 38%. There was frequent upstaging at surgery in all stages except IA. Patients with tumor confined to the uterus at the time of surgery had a 5-year disease-free survival of 52%. When there was extension outside of the uterus, the 5-year disease-free survival dropped to 28%. The locoregional recurrence rate was 17%.