In order to establish the relationship between uraemic polyneuropathy and impairment of renal function, 83 patients with severe renal insufficiency not treated by maintenance dialysis were neurologically examined, most of them repeatedly in the course of their disease. Signs of neuropathy were found only when the creatinine clearance was 5 ml/min or less. The risk of incapacitating neuropathy was present in patients with a creatinine clearance of 3 ml/min or less. Polyneuropathy was found most frequently in patients with the highest blood urea and creatinine levels and the lowest creatinine clearances, but the duration of the period during which renal insufficiency had been severe appeared to be of influence as well. Polyneuropathy could be correlated more closely with the level of breakdown products of protein metabolism in the blood than with the blood creatinine level. The motor conduction velocity of the lateral popliteal nerve was examined in 50 patients. When polyneuropathy progressed, the conduction velocity fell to 50% of the normal value. The protein level of the CSF was raised in most patients with a severe polyneuropathy. Polyneuropathy was assessed in 20 patients treated by maintenance dialysis; it was compared to polyneuropathy in patients without this treatment.