The philosophy pervading our treatment approach to Ewing’s sarcoma has been to have therapy encompass all foci of disease, including sites of occult or potential involvement in addition to obvious clinical manifestations. The experience with integrated methods of treatment in 66 consecutive patients at the National Cancer Institute is reviewed. A median survival of 18 months (44 per cent 2 year survival rate) for patients with recognizable metastases on admission bears impressive witness to the value of adjuvant therapy in Ewing’s sarcoma. Even more encouraging, an uncorrected 5 year survival rate of 53 per cent (42 per cent continuously free of disease) for patients given "prophylactic" adjuvant therapy indicates the potential for permanent control of disease in a significant fraction of cases with clinically localized primary tumors.