Enterohemorrhagic Escherichia coli has been responsible for an increasing number of large food-borne outbreaks of bloody diarrhea and hemolytic uremic syndrome. Recent developments in our understanding of the pathogenesis of disease due to enterhemorrhagic E. coli include the description of a pathogenicity island, a type III secretion system and potential plasmid-encoded virulence factors. Recent developments in our understanding of the epidemiology include a recognition of a widening spectrum of vehicles.