Lactose tolerance tests were performed on 75 healthy Lebanese volunteers, 12 patients with "Mediterranean lymphoma" and 15 American and West European Caucasians. Small intestinal biopsies were done on 10 intolerant and five tolerant subjects for histological evaluation and lactase assay. Lactose malabsorption was present in 78% of the Lebanese subjects, in all patients with Mediterranean lymphoma and in five of the 15 Caucasians. Two of the five intolerant Caucasians had giardiasis. There was no difference in the prevalence rate among the various Lebanese groups nor among males and females. Symptoms occurred in 91% of the 58 intolerant Lebanese subjects: diarrhea in 71%, abdominal distension in 67%, and cramps in 48%. The increased prevalence of lactose intolerance with Mediterranean lymphoma is probably secondary to the pathological changes in the intestinal mucosa and protein depletion.