Our experience with small intestinal neoplasms at the Medical College of Virginia has been reviewed. There were 78 benign and malignant neoplasms observed in our surgical pathology laboratory over a 20-year period. There were 34 benign small-bowel tumors, but the majority of these lesions were asymptomatic incidental findings at the time of surgery for other conditions. There were 21 patients with malignant neoplasms of the small bowel and 23 patients with carcinoid, a potentially malignant lesion. Clinical observations and the results of treatment are reviewed.