Failure to attend scheduled appointments for mammography results in missed opportunities for breast cancer screening. We tested interventions to decrease mammography appointment failure among women attending the medicine clinic at a public teaching hospital. Consecutive women with mammography orders from October 1992 to November 1993 (970 women undergoing 1,072 mammograms) were assigned to one of three comparison groups: usual care, mailed reminder, and mailed reminder plus nurse counseling. The appointment failure rates were 25.5% in the usual care group, 20.3% in the mailed reminder group, and 19.7% in the special intervention group (p = .13). We conclude that mailed reminders modestly improve mammography appointment keeping by about 5%, and that nurse counseling has little additional effect.