Fourteen patients with stage IB or IIA neuroendocrine small-cell cervical cancer were treated either by operation alone or operation in combination with postoperative radiotherapy at the University of California, Irvine Medical Center, and Memorial Medical Center of Long Beach, between January 1979 and February 1986. Patients were included in the study only if they met characteristic light and electron microscopic criteria for neuroendocrine small-cell cancer. Thirteen patients underwent radical hysterectomy and one a simple hysterectomy. All patients underwent pelvic lymphadenectomy, with 57% found to have nodal metastases. Twelve of 14 patients are dead of disease eight to 31 months after treatment, and the two living patients had recurrence at 38 and 44 months. One is without evidence of disease 18 months after radiation for a pelvic recurrence, and the other has survived five months after recurrence without treatment. The interval from treatment to recurrence was substantially longer in patients with tumors up to 2 cm in diameter as compared with those greater than 2 cm. Despite the early stage of cancer in these patients, the dismal outcome indicates that traditional modes of therapy for cervical cancer are not effective in cases of neuroendocrine small-cell carcinoma.