In a necropsy series of 75 patients with endomyocardial fibrosis who died during the years 1967 to 1971 in Mulago Hospital, Kampala, the site of the lesions in the heart was studied alongside with the age, clinical history, geographical distribution, heart weight and concurrent diseases. Most frequently involved were the posterior cusp of the mitral valve, the left ventricular wall (upper-mid and/or apical region) and the right ventricular wall wheras othter localisations turned out to be relatively rare. Intracardial thrombi were also often described. Rheumatic heart disease was the most important concurrent cardiac disorder. The range and variety of the lesions is discussed together with relations to age, sex and geographical distribution of the patients. The results give support to Shaper's hypothesis concerning the aetiology of endomyocardial fibrosis; however many unanswered questions about the disease remain.