Concern over complications of a potentially large outbreak of methicillin-resistant Staphylococcus aureus (MRSA) prompted intensive monitoring and establishment of effective communication lines between infection control practitioners, nurses, physicians, and microbiology personnel. From October, 1986, through September, 1987, 77 patients at the Veterans Administration Medical Center in Oklahoma City had MRSA. Charts were available for review on 63 of these patients. When those with charts available were reviewed, 41 patients had nosocomial (NC) and 22 had community-acquired (CA) MRSA. Of the 41 NC patients, 34 were infected (of which 17 died during hospitalization) and 7 colonized (3 died). Of the 22 CA patients, 15 were infected (4 died) and 7 colonized (2 died). Length of stay was NC-infected, mean 51.8 days; NC-colonized, 38.9 days; CA-infected, 14.9 days; and CA-colonized, 16.1 days. This study shows the importance of NC MRSA, especially as it relates to hospital costs and care of many extended stay patients.