Over the past 20 years there has been considerable interest in the role of CCK receptors in gastrointestinal cancer. Initial excitement over reports of the detection by PCR of CCK-1 and CCK-2 receptor mRNA in a wide range of gastrointestinal tumours has been tempered by the realisation that the presence of receptor binding sites is much more restricted. The current consensus is that expression of CCK-1 and -2 receptor proteins is common only in tumours of neural or neuroendocrine origin. A striking example of this general rule has been provided by the detection of CCK-2 receptors by receptor autoradiography in more than 90% of medullary thyroid carcinomas. Despite the absence of CCK receptors from many gastrointestinal adenocarcinomas, evidence from animal models and from tumour cell lines in vitro suggests that the CCK-2 receptor may contribute to the development of esophageal and gastric adenocarcinomas, and further experimental work in these areas is clearly warranted. Promising therapeutic approaches include the development of radiolabelled gastrin/CCK derivatives for use in tumour imaging, and the use of appropriate selective antagonists for treatment of those tumour subtypes likely to express CCK receptors.