The first naturally acquired case of cholera reported in the United States since 1911 occurred in a 51-year-old resident of Port Lavaca, Texas. Extensive epidemiologic investigation of the patient's contacts and environment did not identify a cholera carrier of elucidate a pathway of transmission, but several avenues of investigation suggested possible means by which the patient may have acquired his infection. No secondary spread resulted from this case, and its occurrence did not endanger the community at large.