Twenty-nine adults operated on for craniopharyngioma between 1970 and 1981 are described. Headache and/or endocrine symptoms often preceded the diagnosis by several years. There were 3 surgical deaths. One patient died accidentally 4 years after surgery. The 5-year survival was 5/5 after total removal, 10/11 after partial removal, 0/3 after palliative surgery; 1/1 after total removal and radiotherapy, 0/2 after partial removal and radiotherapy and 3/3 after palliative surgery and radiotherapy. Visual acuity improved in 9 of 23 patients and deteriorated in 1 patient. Visual fields improved in 8 of 21 patients and deteriorated in 7. Surgery increased the degree of hypopituitarism. Relative body weight increased greater than or equal to 10% by 3 months after surgery in 8 of 15 patients. The prognosis would probably be improved by earlier diagnosis.