The expression of ABO(H) and Lewis blood group antigens on 68 colorectal carcinomas from 63 patients was studied by immunohistochemical staining of tissue specimens. The pattern of antigen expression was as follows: ABH was expressed in normal tissue only in secretors and was expressed in the proximal but not distal colon. In tumors, there was net loss of ABH expression in the proximal and net gain in the distal colon. Some nonsecretor tumor tissue expressed ABH. Lewis expression was similar to but less strong than ABH. Its expression occurred only in secretors and in normal epithelium only in the proximal colon. In tumors there was net loss of antigen expression proximally and net gain in the distal colon. There was no expression of Lewisb in tumors of nonsecretors. Lewisa antigen was expressed throughout the normal colon in secretors and nonsecretors with no discernible difference between proximal and distal colon. In tumors, net loss of expression of Lewisa occurred throughout the colon. No inappropriate blood group expression was observed in this study. With few exceptions, H expression paralleled expression of A and B in non-0 patients. Metastatic tumor antigen expression was similar to that of the primary in most cases. Alterations in antigen expression were not clinically or histologically distinctive.