Abnormal menstrual patterns in 22 women with chronic renal failure are presented. In 4 of these women, ovulatory function was evaluated. Three of the 4 women subjected to the ovulatory study were receivingg maintenance hemodiailysis therapy and the fourth patient studied had severe urenal failure but was receiving medical management only. The nature of the menstrual abnormalily in all 23 women was correlated with the degree of renal failure as estimated by creatinine clearance, endogenous and/or effective. Ovulatury cycles were demonstrated in one woman receiving maintenance hemodialysis therapy. On the basis of three of the four parameters studied, another woman receiving maintenance hemodialysis therapy probably ovulated. Contraceptive therapy is recommended for women in the childbearing age group receiving maintenance hemodiaysis theapy.