Cyclosporin has been suggested as an alternative treatment in severe acute ulcerative colitis. In a retrospective study, the outcome of seven ulcerative colitis patients treated by intravenous cyclosporin (mean dose 3.6 mg/kg/day) has been evaluated. Short-term results indicated full remission in 3/7 (43%) patients. At long term follow-up (one year), only 2/7 patients could avoid ileal pouch-anal anastomosis. Two complications (one colonic perforation and one septicemia) were observed. Our results suggest that intravenous cyclosporin should not be recommended as a standard therapy in severe acute ulcerative colitis. Its use has to be limited in patients presenting a major contraindication for surgery and has to be performed by those experienced in both immunosuppressive treatment and inflammatory bowel disease.