The relative efficacy of sodium and calcium heparin in preventing venous thromboembolism and their relative side-effects were studied in 234 high-risk patients in a randomised, double-blind, placebo-controlled trial. The two heparin preparations were from the same batch and in the same concentration, and were given in a dose of 5000 U 12 hourly. Positive leg scans were found in 19% after placebo, 12% after sodium heparin and 8% after calcium heparin. Bruising at the injection site was more common after calcium heparin (66%) than after sodium heparin (53%) or placebo (38%). Pain at the injection site was also more common after calcium heparin (26%) than after sodium heparin (8%) or placebo (6%). Changes in the activated partial thromboplastin time were small and did not correlate with leg scan results or bruising. While there was a tendency for calcium heparin to be possibly more effective, it was followed by significantly more local haematoma and pain.