The outcome of 114 patients with tumour-induced hypercalcaemia (TIH) treated between January 1992 and June 1993 with intravenous pamidronate (APD) was retrospectively analysed. The median overall survival was 55 days (range 3 days to > 21 months): 86 days if systemic anti-cancer therapy was available and only 35 days if not (P < 0.001). Survival was also significantly better for those who became normocalcaemic post APD (53 days vs 19 days, P < 0.001). There was no survival difference with respect to patient sex, age, tumour type, treatment of bone metastases with radiotherapy, initial calcium level, initial dose of APD or time from tumour diagnosis to first TIH. In those patients in whom systemic anti-cancer therapy is available, treatment with APD improves survival, but in all other patients the primary aim of treatment should be symptom control. This study confirms the dismal prognosis of TIH.