A retrospective study of nine patients with active pyoderma gangrenosum at the time of operation for inflammatory bowel disease showed two patterns of postoperative skin healing: 1) prompt healing within 2 months, occurred in five patients with moderate to severe inflammatory bowel disease. 2) skin disease persisted in four others, healing only after a year. Three of these patients had mild ulcerative colitis, and in them, the operation was carried out in the hope of curing crippling pyoderma gangrenosum. The fourth patient had only an intestinal bypass for ileitis. Our observations suggest that prompt skin healing may occur after surgery in patients with severe inflammatory bowel disease, but not necessarily in those with milder bowel disease or in those in whom some bowel disease persists.