In an experimental study, 13 patients undergoing major elective abdominal surgery were given postoperative transcutaneous electrical muscle stimulation (TEMS) to the quadriceps femoris muscle on one leg; the opposite leg served as control. Changes in cross-sectional area (CSA) and muscle protein synthesis were assessed by computed tomography and ribosome analysis of percutaneous muscle biopsies before surgery and on the sixth postoperative day. The percentage of polyribosomes in the ribosome suspension decreased significantly (P < 0.03) after operation in control legs, but not in stimulated legs (P > 0.16). The total concentration of ribosomes decreased significantly in legs treated with TEMS (P < 0.03) but not in control legs (P > 0.16). CSA decreased significantly in both legs. The decrease in polyribosomes and CSA after operation was significantly less in stimulated legs than in controls (P < 0.05). TEMS may be a simple and effective method for improving muscle protein synthesis and muscle mass after abdominal surgery and should be evaluated in other catabolic states with muscle wasting.