During the past 23 yr, a large number of human illness outbreaks have been traced worldwide to consumption of undercooked ground beef and other beef products contaminated with Shiga toxin-producing Escherichia coli (STEC). Although several routes exist for human infection with STEC, beef remains a main source. Thus, beef cattle are considered reservoirs of O157 and nonO157 STEC. Because of the global nature of the food supply, safety concerns with beef will continue, and the challenges facing the beef industry will increase at the production and processing levels. To be prepared to address these concerns and challenges, it is critical to assess the beef cattle role in human infection with STEC. Because most STEC outbreaks in the United States were traced to beef containing E. coli O157:H7, the epidemiological studies have focused on the prevalence of this serotype in beef and beef cattle. Worldwide, however, additional STEC serotypes (e.g., members of the O26, O91, O103, O111, O118, O145, and O166 serogroups) have been isolated from beef and caused human illnesses ranging from bloody diarrhea and hemorrhagic colitis to the life-threatening hemolytic uremic syndrome (HUS). To provide a global assessment of the STEC problem, published reports on beef and beef cattle in the past 3 decades were evaluated. The prevalence rates of E. coli O157 ranged from 0.1 to 54.2% in ground beef, from 0.1 to 4.4% in sausage, from 1.1 to 36.0% in various retail cuts, and from 0.01 to 43.4% in whole carcasses. The corresponding prevalence rates of nonO157 STEC were 2.4 to 30.0%, 17.0 to 49.2%, 11.4 to 49.6%, and 1.7 to 58.0%, respectively. Of the 162 STEC serotypes isolated from beef products, 43 were detected in HUS patients and 36 are known to cause other human illnesses. With regard to beef cattle, the prevalence rates of E. coli O157 ranged from 0.3 to 19.7% in feedlots and from 0.7 to 27.3% on pasture. The corresponding prevalence rates of nonO157 STEC were 4.6 to 55.9% and 4.7 to 44.8%, respectively. Of the 373 STEC serotypes isolated from cattle feces or hides, 65 were detected in HUS patients and 62 are known to cause other human illnesses. The results indicated the prevalence of a large number of pathogenic STEC in beef and beef cattle at high rates and emphasized the critical need for control measures to assure beef safety.