A 28-year experience with 76 unicameral bone cysts is reviewed and compared to other large series and recommended treatments recorded in the English literature. Particular attention is paid to the importance of recurrence in relation to the need for secondary operations and in contrast to the disability caused by enforced restriction of activity. Evidence is presented suggesting that, in spite of residual radiologic changes, the disability is frequently insufficient to warrant a second operation. Most unicameral bone cysts probably run their own course, not always greatly affected by treatment, with very satisfactory end results.