Recently recurring abdominal pain, bouts of diarrhoea and weight-loss of 15 kg developed in a 50-year-old woman who had for 18 years been treated by diet for nontropical sprue. She was hospitalized for signs of mechanical ileus. Radiological examination revealed three stenosing small intestine tumours, one of them obstructing the lumen. After resection of the affected segments, with end-to-end anastomosis, histological, histological examination of the surgical specimens demonstrated three small intestine carcinomas of different grades of differentiation. The largest tumour had already metastasized to four regional lymph nodes. This case illustrates the potentially precancerous nature of nontropical sprue which has been present for many years and thus requires careful follow-up.