The resected specimens of 24 consecutive patients, who underwent pancreaticoduodenectomy for ampullary carcinoma from 1977 to 1986, were examined pathohistologically and the factors influencing survival were evaluated. According to the pTNM pathological classification, the 5-year survival at Stage I was 100%, at Stage II 64.8% and at Stage III 15%. Only one patient at Stage IV survived more than 5 years. These indicate that the localization of the tumor within the ampulla of Vater and lymph node metastases are worthwhile prognostic indicators. The other factors, such as shape of the tumor, invasion into the veins and lymphatic vessels in the primary lesion, and type of local extension were indicative of influencing survival, but without statistical significance. Tumor size, histological type, and the ratio of connective tissue included in the primary lesion did not correlate with survival.