OBJECTIVE To report our experience of 41 patients with phaeochromocytoma. METHODS Retrospective study. METHODS Teaching hospital, United Kingdom. METHODS Forty-one patients who presented with phaeochromocytoma 1970-1991. METHODS Removal of tumour (n = 38). METHODS Mortality, morbidity, and recurrence. RESULTS Thirty-four patients had sporadic tumours, five had the multiple endocrine neoplasia (MEN) type 2 syndrome, and two had non-MEN familial phaeochromocytoma. Thirty-six patients (88%) presented with symptoms of catecholamine excess, and 37 (90%) were hypertensive. The diagnosis was confirmed biochemically in 37. Tumours were located using computed tomography (n = 26), vascular studies (n = 11), and ultrasonography (n = 3). Thirty-eight patients had their tumours resected, of whom 10 (27%) developed complications. There were no postoperative deaths. Two patients were managed conservatively, and one died before diagnosis. Six patients developed recurrent tumours a mean of five years after the initial operation, and another patient had an inoperable tumour at initial diagnosis; four of these seven died from metastatic disease. Metaiodobenzylguanidine (MIBG) scans were positive in three of the patients who developed recurrences. CONCLUSIONS Patients with phaeochromocytoma can now be operated on safely but prolonged follow-up is essential.