78 patients with anal canal carcinoma were treated between 1970 and 1988 at the University Hospital Erlangen. 48 patients (35 women, 13 men) were treated by surgery alone, 44/48 by abdominoperineal resection, 4/48 by local excision. Median age was 63 years, median follow-up 8.5 years. The overall local recurrence rate was 16.7%, the overall five-year-survival was 51%. 30 patients received a combined radio-chemotherapy. The small pelvis was treated with a.-p./p.-a. fields up to a total dose between 42 and 50 Gy. Two courses of chemotherapy consisting of 5-FU (800 to 1000 mg/m2 days 1 to 4 and 29 to 32) and Mitomycin C (10 mg/m2 days 1 and 29) were administered. Two months after completion of treatment 83% had a biopsy proven complete remission. After a median follow-up of 15 months 87% are alive with NED, 74% are continent. The combined regimen of radio-chemotherapy is considered as the treatment of the choice for anal canal carcinoma. Abdominoperineal resection is only performed in patients with non response or local recurrent disease.