SUMMARY An account is given of fifty cases of hemimandibulectomy, thirty-three of whom had block dissection of the neck. Problems which the anaesthetist is likely to meet in patients with malignant disease undergoing this operation are: respiratory and cardiovascular disease, poor nutrition and hypovolaemia, the local sequelae of intensive pre-operative radiotherapy, and intra-oral and pharyngeal suppuration. A suitable method of anaesthesia and controlled hypotension is described. Complications occurring during the operation were few, but included two cases of parasympathetic reflex disturbance. Postoperative complications included respiratory obstruction, persistent hypotension and reactionary haemorrhage following the use of controlled hypotension. The indications for tracheostomv in these patients are discussed.