Home elemental nutrition (HEN) was used in 11 children and adolescents with complicated Crohn's disease to relieve their immediate symptoms and make them more fit for definitive surgery. HEN resulted in symptomatic relief, weight gain from a mean of 47 to 53 kg (P less than .001) and reduction in prednisone requirements from a mean daily dose of 30 to 6 mg (P less than .001). The seven patients who subsequently underwent definitive bowel resection suffered no surgical complications. HEN was well tolerated by all patients. HEN offers a simple, safe, and cost effective means of preparing patients with complicated Crohn's disease for operation.