It is well established that primates suffer and may survive illness and injury in the wild, but more equivocal is our understanding of how these affect reproductive fitness. This paper presents a functional and evolutionary framework for assessing nonhuman primate illness and injury by examining their timing in primate life history and their associations to subsistence, locomotion, and social behavior. The selective impact of illness and injury may take several forms, by affecting reproductive success through subadult mortality, mortality during reproductive years, restriction of a female's ability to care for her offspring, and impairment of male and female competition for mates.Analysis may be made at the individual, local populational, or phylogenetic level. The available data indicate that there is considerable variability in the reproductive impact of illness and injury, and that the time of their occurrence in the life cycle is crucial. Broad distinctions in dietary strategies, locomotion, and social behaviors among primates are shown to be of limited use in interpreting evolutionary effects, and the observed variability in pathological profiles at the phylogenetic level suggests that smaller scale distinctions should be employed in future analyses. In addition, methodological inconsistencies seriously hamper these comparative studies.With the steady increase in information on health and mortality patterns emerging from long-term field studies, integrated research efforts in ethology and osteology should permit us to go beyond this theoretical framework and demonstrate empirically the role of illness and injury in primate evolution.One cannot but feel certain that disease in its various manifestations has played a much greater part in the evolution of different forms of life in this world than the biologists have ever realised. JCM Given (1928:166) It can hardly be doubted that this great variety of pathological conditions, found among apes and monkeys of today, is not a sudden, new development, but existed at all stages of primate evolution with only detailed and no principal change. In the early history of mankind diseases and injuries must also have played important roles.AH Schultz (1956:984) 0 1991 Wiley-Liss, Inc. [Vol. 34, 1991 Descriptive narratives about medical curiosities and anomalies in the skeleton and dentition of nonhuman primates have been reported regularly in the literature since the late 1800s (e.g., Bolau, 1877; Ranke, 1899; Rollet, 1891; Sutton, 18841, and systematic reviews of pathological conditions appeared more than 50 years ago (e.g., Moodie, 1923;Colyer, 1936;Schultz, 1935). Only very recently, however, has problem-oriented research been attempted, although earlier identification of related pathological conditions in humans and nonhuman primates and the exploration of behavioral links to patterns of injury and illness are seen in the works of Adolph Schultz. Schultz was the founder of systematic research into skeletal and dental diseases of nonhuman primates and ...