Twenty cases of Group A beta-hemolytic streptococcal bacteremia in children diagnosed between 1980 and 1987 are reported. Most cases occurred during the winter. The skin and soft tissues were the most common sources of the Group A beta-hemolytic streptococcal bacteremia. Three patients died. Two separate groups of children were observed: (1) a group of 12 young, well-nourished, previously healthy infants, who did not generally develop focal complications and had a favorable course; (2) a group of 8 older children suffering from malnutrition and underlying diseases, such as psychomotor retardation, infected hemangiomata, hemophilia and acute hepatitis B who commonly had focal infections such as pneumonia, meningitis or arthritis/osteomyelitis and had a worse prognosis. M protein-typable strains traditionally related to Group A beta-hemolytic Strep-tococcus virulence were an inconstant finding in this series.