Eight patients with ileo-rectal anastomosis following a total colectomy for familial polyposis coli underwent Nd: YAG laser therapy to treat recurrent adenomas in the preserved rectum after the operation. The median follow-up period for these eight patients has been 4 years and 7 months. Of the eight patients, one underwent a mucosectomy of the preserved rectum and an ileo-anal pull-through five years after the first operation because of recurrent diffuse polyposis of the preserved rectum. In the remaining seven patients, Nd:YAG laser therapy was found to be effective in the abration of recurrent polyps.