The striking alterations of the skeletal, muscular, dermal and nervous systems produced by a chromophilic adenoma of the pituitary body have been adequately described by many observers. The changes produced in the cardiovascular system of patients with acromegaly, although the direct cause of death in the majority of instances, have been infrequently described and insufficiently studied. We have been impressed by the frequency with which weakness, syncope and the more common symptoms of cardiac failure have dominated the terminal clinical course in these cases. This circumstance has often been neglected because attention has been fixed on the more spectacular features of the disease, especially the surgical aspects. On this account, recent medical reports usually fail to describe adequately the changes in the cardiovascular system. We have had occasion to study a small number of patients with acromegaly with reference to the cardiovascular system both during life and at postmortem examination,