This report, which forms volume 10 in the Chichester Excavations series, describes and discusses the excavation in 1986-87 and 1993 of almost 400 skeletons from the cemetery of the Hospital of St James and St Mary Magdalene just outside Chichester, West Sussex. Founded as a leper hospital for men in the 12th century, this institution admitted women and children towards the end of the Middle Ages and survived the Reformation by becoming an almshouse for the sick poor. Part 1 of the report discusses leprosy and contemporary attitudes to it, medieval hospitals and cemeteries, and the provision of charitable care in medieval Chichester. Part 2 focuses specifically on St James's Hospital and the archaeology of its cemetery, including dating, layout and the distribution of individuals according to age at death, sex and disease. Part 3 examines the physical anthropology and palaeopathology of this unique assemblage of skeletons, discussing leprosy, other diseases, dental health, trauma and osteoarthritis. Part 4 comprises the discussion and interpretation of the site, emphasising the change in the pattern of disease through the period of occupation from the early 12th to the mid-17th century, reflecting both the decline in leprosy in England and the refounding of the hospital as an almshouse.