Researchers have endeavored to define surface alterations associated with neoplasia for at least 25 years. In comparisons of normal tissues with animal and human tumors, cultured cells before and after transformation with oncogenic agents, tumorigenic and nontumorigenic transformed cells, metastatic and nonmetastatic tumor cells, high- and low-metastatic variants, and tumor cells before and after induction of differentiation to a less malignant phenotype, a consistent finding has been some form of alteration in surface carbohydrate structures. These changes in glycolipids, glycoproteins and glycosaminoglycans are reviewed, and their structures are illustrated. Both nucleotide sugar biosynthesis and glycosyltransferase changes have been associated with these alterations. In some cases, alterations in transformed cells were related to growth, rather than transformation. In others, the altered glycoconjugates are truly tumor-associated. There is evidence that cell surface glycoconjugates may function in growth control. Altered carbohydrate structures could also serve as receptors for growth promoting factors and be directly responsible for altered growth control. Recent studies with monoclonal antibodies indicate that the vast majority of antibodies recognizing tumor-associated antigens are detecting altered carbohydrate structures. Mechanisms by which the immune system can recognize these carbohydrate structures are considered, and immune recognition of tumor-associated carbohydrate structural alterations is explored. A number of these hypotheses relating to alterations in glycosylation, growth control, and tumor immunity deserve further investigation.