More than 1,000 lobotomized patients have been followed for periods of 1 to 16 years, then divided into those with good social achievement and those with poor social achievement. The records were analyzed in an effort to determine the factors responsible for good adjustment. It was found that the level of achievement improved with the passage of time.The outstanding feature in a high level of achievement is the short duration of disability. Since community activities and professional competence are possible after lobotomy, it is apparent that the personality downgrading generally attributed to lobotomy should be attributed rather to the devastating effects of the underlying disease process. It is safer to operate than to wait.Transorbital lobotomy yields a higher rate of good social achievement than prefrontal lobotomy except in cases of hebephrenic schizophrenia.Abstract Teaser