An increasingly large number of patients suffer from the various manifestations of fecal impaction. Proper management of the condition will prevent much suffering, many laparotomies, and even colostomies. Fecal impaction is defined as the presence in the rectum or colon of firm stercus which can be dislodged only with the aid of the finger, enemas, or operation. Organic causes include obstructing lesions, anal fissure, and diseases such as magacolon, general paresis, and infantile paralysis. Fecal impaction occurs at any age and can mimic other diseases by producing symptoms suggesting diarrhea, tumor, or urinary calculi. Physical examination may reveal a hard fecal mass in the rectum, a hard, putty-like mass at the end of the sigmoidoscope, distended abdomen, or palpable hard lumps in the abdomen. Impacted scybala in the lower part of the sigmoid may be dislodged by pelvic, abdominal, or sigmoidoscopic manipulation. Colonic irrigation is a pertinent form of therapy for suspected impactions higher in the colon. Two typical case histories are presented.