The results of the Cornell Elective Surgery Second Opinion Program are presented. From February 1972 to January 1978, 7053 patients were evaluated for proposed elective surgery, and in 27.6% of these, the operations were not approved. The subspecialties of orthopedics and gynecology demonstrated the highest rates of non-confirmation, while that for general surgery was 18%. A group of 318 patients with general surgical diagnosis are reviewed. The percentage of nonconfirmed surgery for this group was 15 percent. The most common reasons for not approving the operations were absence of pathology and failure to utilize medical therapy when indicated.