The response of the intestinal mucosa to Adriamycin (ADR) was studied in the duodenum, jejunum, and ileum of 25-day-old rats. A single injection of ADR resulted in decreases in mucosal DNA per centimeter of length and in sucrase activity, which were proportional to the doses given (2, 5, and 8 mg/kg). ADR at 2 mg/kg had no significant effect on body weight, gut length, epithelial structure, or mucosal protein content per unit length. The morphological modifications occurred mostly in the proximal intestine and consisted of villous atrophy and degenerative changes of villus and crypt cells. A single dose of 5 mg ADR/kg acutely affected the gut. At 48 and 96 h the changes were characterized by marked decreases in mucosal weight, DNA per centimeter, sucrase activity, and villous shortening. At 144 h, the ADR-treated intestine entered a highly proliferative state and showed increased villous height, mucosal weight, and DNA per centimeter. Although villous hyperplasia was observed at 144 and 192 h, the mucosal weight and DNA concentrations did not exceed the corresponding levels in the control. During the period of active epithelial proliferation, sucrase activity remained depressed. We conclude that in the growing rat: (a) the acute intestinal injury of ADR is short-lived, dose dependent, and predominates in the proximal small intestine; (b) the enteric mucosa reacts to cytotoxic injury by excessive proliferation of immature enterocytes; and (c) the hyperplastic response to ADR is confined to the mucosal epithelium.