The threat of premature death in the fourth or fifth decades of life from cardiorespiratory failure in kyphoscoliosis is well known. Ten patients with severe kyphoscoliosis (curves greater than 100 degrees), who had survived into their seventh decade free of cardiorespiratory failure, were encountered over a four-year period. Pulmonary function studies on five patients showed impaired chest bellows function. Four patients died of acute respiratory failure at ages 65, 73, 79, and 85. These patients illustrate that severe deformity is not incompatible with a long and active life.