The records of 36 patients who underwent subxiphoid pericardiotomy were reviewed to determine the safety, accuracy, and utility of the procedure. No deaths were attributed to the operation, and complications were minimal. Most operations were performed under local anesthesia. Findings at operation accurately defined which patients required further surgery and which did not. Although clinical, radiographic, and physical findings are inaccurate in determining the nature and extent of pericardial and intrapericardial pathology, a definitive diagnosis was obtained in all diagnostic procedures. Only one patient needed a second operation, attesting to the effectiveness of subxiphoid drainage as a therapeutic modality.