The cases of 43 patients with hypoproteinemic hypertrophic gastropathy (Ménétrièr's disease) seen at the Mayo Clinic during 1970 to 1980 are reviewed. Characteristically, patients with Ménétrièr's disease are older than 60 years of age and have epigastric pain, weight loss, nausea, diarrhea, and dyspepsia, with or without a history of peptic ulcer disease. Ménétrièr's disease can be associated with swelling in the extremities, vomiting and early satiety, maculopapular rash, anorexia, and fatigue. In our patients, unlike those with hypertrophic gastropathy without hypoproteinemia, Ménétrièr's disease was accompanied by an increased incidence of severe or recurrent infections (18 patients); occlusive, thromboembolic, and other vascular disorders (23 patients); and pulmonary edema (13 patients). Remission can occur after parietal cell vagotomy or histamine-H2-receptor blockade, or spontaneously; however, in most patients, rugal enlargement and hypoproteinemia persist for long periods of time.