From a population of 278 patients with multiple handicaps of many varieties, the outcome in 32 cases is summarized. These 32 cases were selected by death or because the patient reached young adulthood. Six (19%) may be considered successful and another six (19%) may have a remote potential for success. The remaining 20 patients (62%) are either dead (9 patients) or absolute failures (11 patients). Failure may be due to a lack of medical knowledge, poor environment, or a combination of organic and psychological problems. Success depends on good follow-up and on an effective school and vocational plan. A vocational plan instituted at a time which is ideal should lead to an effective level of motivation.