We have studied the severity and duration of nocturnal hypoxaemia before operation and for the first five nights after operation after elective major abdominal vascular surgery. Oxygen supplementation was almost 100% effective in keeping oxygen saturation greater than 90% during the early postoperative period; however, 50% of patients spent prolonged periods with an SpO2 less than 85% during at least one night after operation. The risk of severe hypoxaemia persists well beyond the current prescription of supplementary oxygen in these high risk patients. A significant association exists between the mean preoperative overnight saturation value and the nocturnal saturation observed subsequently in the later postoperative period.