OBJECTIVE To evaluate the long term clinical performance of the Schering Nova-T 200 intrauterine contraceptive device. METHODS From 1982 to 1990, 446 women were fitted with their first Nova-T IUD's and followed up until December 1994. By this cut off data, 21 (4.7%) were lost to follow up. These were excluded to simplify analysis. RESULTS Of the remaining 425 women, there were 383 multipara and 42 nullipara. Thirty one percent were fitted with a new Nova-T after 4 years of use. The method was uncomplicated in 70% of multiparous women, but in nulliparous users, the removal rate for unacceptable bleeding and/or pain was found to be 40% compared to 19% for the multipara. An expulsion rate of 4.9% was recorded. The overall cumulative accidental pregnancy rate was 3.5% with a Pearl Index of 1.2 per hundred woman years, a lower rate in older users being the only age related event in the study. Possible pelvic inflammatory disease was recorded in 2.8% with a Pearl index of 0.96. There was no evidence of subfertility after removal in any of the 53 women where a pregnancy was desired. CONCLUSIONS The Nova-T 200 IUCD is safe and cost effective and should continue to be offered as a contraceptive option for properly selected women. Although poorly tolerated by nullipara, it proved to be very satisfactory for multiparous women, particularly nursing mothers and those over 40 years of age.