Data on 121 primary above-knee amputations and 12 stump revisions performed on a population of nonambulatory elderly psychiatric inpatients showed that the overall morbidity and mortality rates compared favorably with those in previously published reports on other groups of patients who received the same type of amputations, despite the precarious health of the psychiatric patients. By use of spinal anesthesia; meticulous attention to the prevention, early detection, and prompt treatment of wound complications; and identification of patients at high risk, this often desperately needed operation can be performed with good results.