Highly selective vagotomy was performed in 361 patients over the past 10 years. The mortality was 0.3% in uncomplicated, and 1.6% in complicated duodenal ulcer. With a mean follow-up period of 52 months the recurrence rate was 7.4%. The known advantages of this operation, namely low mortality and low postoperative morbidity (dumping 0.8%, diarrhoea 0.8%, unintentional weight loss 0%, food intolerance 1.9% and epigastric fullness after meals 1.9%), were confirmed in our patients. The overall clinical result was excellent or good (Visick I or II) in 87% of patients. Clinical failures were most often caused by recurrent ulceration. Highly selective vagotomy is still the operation of choice in uncomplicated duodenal ulcer. It can also be recommended in selected cases of complicated ulcer disease.