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Balsalazide (BSZ) is a pro-drug which releases 5-aminosalicylic acid (5ASA) and 4-aminobenzoyl-~-alanine (an inert carrier) in the colon of various species including man. BSZ was compared with sulphasalazine (SASP) (both I g b.d. orally) in the maintenance of remission in patients with ulcerative colitis (UC). Seventy-nine patients (53 male, 26 female), mean age 49 years (range 19-79 years), with UC were randomly allocated to either treatment (41 BSZ, 38 SASP) for 6 months. The groups were similar in respect of age, sex, duration and extent of disease. Seven patients defaulted (3 BSZ, 4 SASP) leaving 38 on BSZ and 34 on SASP.Two male patients, both receiving SASP, were withdrawn because of severe side-effects. One of these patients, with an exfoliative rash, was maintained satisfactorily on open BSZ. Remission rates at 6 months (5 1 % BSZ, 63 % SASP) were not significantly different (life-table analysis P < 0.1). Twelve patients (15 %) reported troublesome side-effects (2 BSZ 5 YO, 10 SASP 26%, P = 0.017 Fisher Exact Test). Mean haemoglobin concentrations, similar on entry, increased after 6 months with BSZ (0.2 g/dl) but decreased with SASP (0.5 g/dl) (P < 0.0OOZ). BSZ was not significantly different from SASP in maintaining remission in patients with UC but had fewer side-effects. Correspondence to: Professor 1. E. Lennard-Jones, St Marks Hospital, City Road, London EC1V ZPS, LJK 23 7 238 P. B. McINTYRE ef al.