The patient with a cryptorchid testis is prone to infertility and testicular malignancy. Optimal treatment of cryptorchidism has been considered orchiopexy at the second year of life. In the past 10 years, we have treated 40 patients, 11-63 years old (mean 25), who presented with a cryptorchid testis at or after puberty. Orchiectomy was performed in all, and spermatogenesis was present in only 2 of the 40. Testicular diameter was greater than 3 cm in 32 of the 38 patients with an atrophic testis. Malignant tumors were found in 6 patients (15%) at operation. A seminoma was found in 5 patients operated on at ages 21, 23, 27, 47 and 63 years, and a nonseminomatous tumor in a 31-year-old. In 2 who underwent orchiopexy at ages 9 and 17 years, respectively, testicular tumors were found at ages 27 and 31 years. We conclude that a patient with a cryptorchid testis who presents at or after puberty should undergo orchiectomy as soon as possible. The prospect for such a testis to contribute to fertility is negligible, even if its diameter is normal, whereas the risk of developing malignancy is high.