Seven adults with acute leukemia had a clinical and radiologic diagnosis of neutropenic enterocolitis. Six of the seven patients had granulocyte counts less than 500/microliter. All seven patients responded to intensive medical therapy, including bowel rest, broad spectrum antibiotics, and white blood cell transfusions, and recovered from the neutropenic enterocolitis without surgical intervention. We discuss the clinical spectrum of neutropenic enterocolitis and the favorable results of medical therapy.