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Congenital megacolon of the obstructive type, currently attributed to agenesis of the intramural plexuses in the contiguous distal segment, is amenable to surgical treatment. Resection of either the distal neurogenically obstructive segment or the dilated proximal segment, contrastingly different procedures, results in anatomic and functional improvement. Three cases, herein reported, treated by resection of the dilated segment, demonstrate that the preferential choice of resection of the neurogenically obstructive segment may be on an equivocal physiologic basis. The new operations developed for eliminating the neurogenically obstructive segment appear to be an advancement in surgical technic.