In order to study temporal changes in surgical rates for peptic ulcer disease a survey investigation covering 82% of the surgical departments in Sweden was made. Since 1956 there was a marked and steady decline in elective procedures while the decline in emergency procedures for perforations was much less pronounced. In 1986, the incidence of elective and emergency operations was 1.2 and 0.6 procedures per 10,000 inhabitants, respectively. In the future, the few patients needing elective surgery for peptic ulcer may have to be served by a small number of specialized centres.