One hundred and eight cases of human protothecosis occurring over 25 years are reviewed. The most common species isolated was Prototheca wickerhamii, The algae have been isolated from a large number of sites but seem to have low virulence. In the majority of systemic infections there have been few symptoms. Cutaneous manifestations may vary from patient to patient but infections of immunosuppressed patients tend to be more florid. Most cases have been successfully treated by excising the lesion or with antifungals. Most strains are sensitive to 5-fluorocytosine, amphotericin B and the azoles but resistance does occur.