Our experience with 27 patients undergoing 33 Altemeier procedures for repair of rectal prolapse is presented. The overall recurrence rate during a 1- to 17-year follow-up period is 35 per cent (per patients) or 50 per cent (per operations). There was no mortality and only minimal morbidity, although we were dealing with an elderly group of patients (average age 61 years) with many associated diseases (2.8 diseases per patient). Of 13 patients with successful anatomic repair, ten described it as a success, one developed an anal stricture, and two patients claimed only partial success, despite a perfect anatomic repair, due to lack of improved continence. Our results with the Altemeier procedure for the repair of rectal prolapse are unsatisfactory. However, as the procedure is well tolerated by elderly and sick patients, it should be reserved for those.