This paper reviews the outcomes for 14 patients treated with long-term home parenteral nutrition at the Royal Prince Alfred Hospital between 1978 and 1994. Prior to the introduction of home parenteral nutrition, all patients were unable to maintain adequate nutrition by enteral means and all had experienced repeated and/or long term admissions to hospital for total parenteral nutrition. The median time patients had been on home parenteral nutrition was 468 days (range 7 days to 5,352 days) and seven patients were on home parenteral nutrition at the time of the review. The majority of patients were able to resume a reasonable place in society for varying periods and four of the patients returned to work. The conclusion from the Royal Prince Alfred experience is that home parenteral nutrition is a cost-effective method of maintaining nutrition in selected patients with chronic intestinal failure.