Group B streptococcus was isolated from the blood, penile exudate and needle aspirate of cellulitis in a severely ill neonate with a rapidly progressive infection of the scrotum, penis and lower abdominal wall. This case demonstrates the need to evaluate and to manage newborns with scrotal cellulitis differently than older children and adults. A different group of organisms and a greater likelihood for systemic involvement are to be anticipated in newborns.