Patients presenting with adenocarcinoma of the vermiform appendix at the Royal Preston and Chorley District General Hospitals were reviewed for the 15 year period 1972–1986. Eleven cases were identified, representing a rate of 1 in 956 for all appendicectomies performed. A third of the cases presented as acute appendicitis. However, of 8 patients who initially had an appendicectomy, only 4 subsequently underwent further surgery (right hemicolectomy). One patient died of recurrent disease. Five of the patients presenting were under 60 years of age. During the same period, the total number of appendicectomies performed annually declined by 50%. The study highlights the need to subject all appendicectomy specimens to histological examination, and that the disease presents in a younger age group than commonly seen for malignant colonic neoplasms.