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The survival patterns of 90 patients with advanced pelvic malignancy and bilateral ureteral obstruction treated with urinary diversion are reviewed. Cell type, presence or absence of prior treatment, or degree of renal decompensation had no specific correlation with length of survival. The youngest age group ranging from 27 to 49 years had a significantly shorter survival than the remainder of the patients. In patients who received prior treatment, an increasing time interval from original diagnosis of malignancy to diversion was associated with a longer median survival. Thirty patients lived six months or more after surgery and spent an average of 14% of their remaining life in the hospital. Guidelines for selection of patients who might benefit from urinary diversion are presented.