PURPOSE This study involved a prospective evaluation of the results of the balloon catheter dilation of lower gastrointestinal stenoses. METHODS First a guide-wire was introduced into the stenosis followed under x-ray control by a double-lumen balloon catheter, or directly through the endoscope a balloon catheter, with progressive dilation under pressures of 1.5 to 3 atm. The result was assessed via the decreased indentation of the balloon and the increased diameter of the stenosis. RESULTS Between January 1985 and November 2002, 133 dilations were performed on 57 patients. The cause of the stenosis was postoperative stenosis in 44 patients, Crohn's disease in 6, ulcerative colitis in 2, postirradiative stenosis in 1, ischemic stenosis in 1, and scarring of the anus in 3 patients. Four of the stenoses were localized to the anus, 45 to the rectum, 7 to the colon, and 1 to the terminal ileum. The average diameter of the stenosis was increased from 7.2 (range, 1-14) mm to 19.7 (range, 14-25) mm. Colostomies were closed in 11 of 17 cases. In five patients, the ileus state ceased, and the three colocutaneous fistulas healed rapidly. In 17 of 57 patients, reoperation was proposed. In one patient, fever as a complication was treated with antibiotics. CONCLUSIONS The dilation of benign stenoses of the lower gastrointestinal tract with a balloon catheter is an effective and safe method, which in most cases (70 percent) results in long-term elimination of the obstructive symptoms, so that surgery can be avoided.