A prospective randomized study on sixty patients was conducted to investigate the effects of a fish oil containing total parenteral nutrition (TPN) regimen in the postoperative period on lymphocyte subset distribution, proliferation, cytokine production and interleukin-2 receptor (IL-2R) expression. Patients who underwent large bowel surgery were divided into three groups. Nineteen patients received TPN with fish oil (0 : 2 g/kg body weight per day) plus soybean oil (1 : 0 g/kg per day), twenty patients received soybean oil (1 : 2 g/kg per day), and twenty-one patients who were on a fat-free regimen served as the control group. Natural killer (NK) cells, total, B-, T-, T 4 -, T 8 -lymphocytes, proliferation of lymphocytes, in vitro production of IL-2, IFN-g, TNF-a, and IL-2R expression were measured. Fish oil administration did not affect subset distribution and proliferation of lymphocytes. Production of interleukin-2 (IL-2), interferon g (IFN-g) and tumor necrosis factor a (TNF-a) was augmented, and IL-2R expression less enhanced compared with the controls. It is concluded that administration of 0 : 2 g/kg per day fish oil after a moderate surgical stress is not immunosuppressive, but enhances the production of IFN-g, TNF-a and possibly IL-2.