To study the clinical picture and survival of chronic active hepatitis (CAH) in Hong Kong, the records of 298 non-alcoholic patients with histologically proven CAH were reviewed. The male:female ratio was 3:1. The mean age (+/- SD) on presentation was 47.3 (+/- 13.1) years. The liver was shrunken and the mean mass (+/- SD) at autopsy was 887 gm (+/- 266) compared to 1343 gm (+/- 172) in cases without liver disease. The spleen was enlarged to 2 to 20 cm below the left costal margin in 98% of cases. The survival graph showed an annual mortality of approximately 13%, without a tendency to flatten out within ten years of diagnosis. Survival was best in patients presenting with splenomegaly alone, average in those presenting with ascites or gastrointestinal haemorrhage and worst in those presenting with hepatic decompensation. The modes of death were significantly correlated with the chief complaints on first presentation (p less than 0.001). The study documented the clinical aspects of CAH in Hong Kong and amplified the differences reported among CAH patients between Australia and Asia.