The comparative efficacy and patient compliance with treatment using three sustained-release theophylline preparations currently available in The Netherlands were evaluated by measuring the plasma concentration achieved in a survey of 282 hospital and 185 out-patients. Compliance was dramatically better amongst in-patients than those attending out-patient clinics. Complete treatment avoidance was higher than expected. Compliance was better among non-smokers than among patients who were still smoking. Patients clearly preferred preparations which permitted a simple daily dosing schedule requiring the minimum number of tablets. On this basis and that of the parameters measured, Theolair Retard was the preparation of choice. Plasma concentration should be monitored during long-term theophylline treatment.