Sprue is a chronic inflammatory process of the mucous membranes of the entire alimentary tract, characterized by the passage of copious, large, fermenting stools with greater or less frequency, accompanied by progressive wasting, macrocytic anemia, defective intestinal absorption, and limited largely or entirely to an endemic tropical and sub-tropical distribution. While it has been reported from more northerly countries, and develops in north China, it is essentially a tropical disease, and one of the most interesting and important diseases of warm countries. In California it is frequently seen in imported cases, but no autochthonous authentic cases have been reported. It is of particular interest in California for two reasons: (a) Imported cases are fairly common. (b) Its clinical and pathologic syndromes easily overlap and are confused with more common conditions of local origin which may be etiologically related.