Post-weaning Escherichia coli diarrhea (PWECD) in Ontario was investigated using a case-control study involving 50 Ontario nurseries. The clinical signs and the impact on productive parameters were determined by means of a producer survey. The hemolytic E. coli serogroups involved in PWECD (O149:K91:K88) were examined in this study. Based on a polymerase chain reaction test, the hemolytic E. coli from 82% of the case herds were positive for 3 enterotoxins (STa, STb, and LT), those from 12% of the case herds were positive for STb and LT only, and those from one herd (6%) were positive for 3 enterotoxins, as well as for verotoxin and F18 pili. The E. coli involved in disease were resistant to multiple antibiotics. Case farms commonly used a wide variety of antibiotics either in the feed or water, or as injectable drugs. The most common antibiotic used to treat PWECD on the study farms was apramycin, but evidence of resistance to this antibiotic was noted. The PWECD problem was commonly seen within a week of weaning but onset of diarrhea was reported as late as the grower-finisher stage. Growth rate was poorer in case herds and mortality was higher than in control herds, demonstrating that PWECD is an economically important disease in Ontario.