The effect of neostigmine on postoperative intestinal paralysis in 90 patients was investigated in a controlled study. Neostigmine, 0.5 mg, was administered intramuscularly every third hour on the third day after laparotomy, either until passage of flatus or stools was observed, or until a total of three injections were given. No difference between treated and untreated patients was found, and it is suggested that neostigmine is of little or no value in postoperative intestinal paralysis.