Ligation of the internal iliac arteries may be life-saving in the control of severe pelvic hemorrhage occurring spontaneously or operatively. This operation was done in 60 patients. It was unilateral in 15 and bilateral in 45. In addition, both ovarian arteries were ligated in 15 of the latter group, so that in these women all 4 vessels were ligated. Nevertheless, collateral circulation was adequate in all patients, and no sloughs followed. No deaths or serious complications resulted directly from the arterial ligation itself. Hemorrhage was effectively controlled in 53 of the women. Because of the effectiveness, simplicity, and safety of ligating the internal iliac artery, the operation deserves greater emphasis than it has received in the past.