An overview is given of the various aspects of idiopathic proctitis. Special emphasis is given on the diagnostic possibilities especially the endoscopic appearances. The list of other inflammatory conditions to be considered in the differential diagnosis is long and includes especially infectious disorders, Crohn's disease, post-radiation abnormalities, caustic damage and ischaemic damage. The mainstay of therapy is topical application of measalazine and corticosteroids. In general measalazine appears to be equally effective as corticosteroids.