We reviewed cases of Kawasaki syndrome reported to the Wisconsin Division of Health and occurring in Wisconsin residents with illness onsets between 1982 and 1989. Of 164 reports, there were 73 confirmed cases that met the Centers for Disease Control case definition criteria for Kawasaki syndrome, 87 probable cases, and four non-cases. Confirmed cases were reported in residents of all five Wisconsin public health regions. The Wisconsin data was demographically similar to national data: 80% of the cases occurred in children younger than 5 years old, the mean annual incidence rate was highest in children 12 to 23 months of age, males were affected more often than females, and the incidence rate was higher among non-white children than among white children. Coronary artery aneurysms occurred in 16% of the patients with confirmed cases. Males developed aneurysms significantly more often than females, and aneurysm formation did not correlate with age. Kawasaki syndrome continues to occur in Wisconsin, and complete and accurate reporting of the disease will enhance the understanding of its natural history and etiology.