Increased awareness of the high prevalence of celiac disease and the degree of underdiagnosis has led to calls for routine screening in certain groups. The potential consequences of underdiagnosis have been the subject of several studies. Where there is a delay in diagnosis, there may be an increased risk of associated autoimmune diseases. Alternatively, there may be marked neurological complications, or fetal growth retardation where pregnancy preceeds diagnosis. Once a diagnosis is obtained, treatment may become easier with further evidence that oats are well tolerated by most people with celiac disease. Screening will be facilitated by the development of highly sensitive and specific enzyme-linked immunosorbent assays for tissue transglutaminase. Further insights into the genetics of the condition have been gained with the discovery of a new human leukocyte antigen susceptibility type, plus a possible non-human-leukocyte antigen susceptibility gene. Curr Opin Gastroenterol 2000, 16:102–106 © 2000 Lippincott William & Wilkins, Inc.