Susceptibility to coeliac disease involves HLA and non-HLA-linked genes. The CTLA4\CD28 gene region encodes immune regulatory T-cell surface molecules and is a strong candidate as a susceptibility locus. We evaluated CTLA4\CD28 in coeliac disease by genetic linkage and association and combined our findings with published studies through a meta-analysis. 116 multiplex families were genotyped across CTLA4\CD28 using eight markers. The contribution of CTLA4\CD28 to coeliac disease was assessed by non-parametric linkage and association analyses. Seven studies were identified that had evaluated the relationship between CTLA4\CD28 and coeliac disease and a pooled analysis of data undertaken. In our study there was evidence for a relationship between variation in the CTLA4\CD28 region and coeliac disease by linkage and association analyses. However, the findings did not attain formal statistical significance ( p l 0n004 and 0n039, respectively). Pooling findings with published results showed significant evidence for linkage (504 families) and association (940 families) : p values, 0n0001 and 0n0014 at D2S2214, respectively, and 0n0008 and 0n0006 at D2S116, respectively. These findings suggest that variation in the CD28\CTLA4 gene region is a determinant of coeliac disease susceptibility. Dissecting the sequence variation underlying this relationship will depend on further analyses utilising denser sets of markers.