Natural killer (NK) cells are the subject of great current interest because of their possible (in vivo) role in tumour cell surveillance and killing, and because of the potential application of cytokine-modulated NK cells in cancer immunotherapy. In addition, clonal proliferations of NK-associated (NKa) cell populations represent a high proportion of chronic (non-B) lymphoid malignancies and abnormal (both clonal and non-clonal) NKa components are being increasingly reported in association with diverse clinical pictures such as autoimmune disease. This communication extensively reviews what is presently known regarding normal and leukaemic NKa phenotypic diversity, the mechanisms of NK-mediated cytolysis, the role of NK cells in malignancy, and the diagnostic and cellular aspects of malignant NKa proliferations.