Of 120 patients treated definitively at University of Texas System Cancer Center, M. D. Anderson Hospital for malignant mixed müllerian tumor of the uterus, 67 had their tumors recur. These patients were analyzed for recurrence pattern and response of recurrence to treatment. The most frequent sites of recurrence were the lung and abdomen, accounting for 66% of all first-site recurrences and 80% of all first-site distant metastases. Locoregional recurrences were much less frequent, accounting for 18% of recurrences. There was no apparent change in recurrence pattern with the addition of adjuvant chemotherapy. The effect of adjuvant radiation could not be assessed, because 95% of patients treated surgically received adjunctive radiation. The survival after treatment of recurrence was shortest for patients with bone, brain, or liver metastases (median, 4 months). There were four long-term survivors (more than 36 months). Patients with resectable recurrences had the highest response rates. Response to chemotherapy alone was uniformly poor (6% response rate).