The pancreases from 250 children with fatal infections caused by at least fourteen different viruses were examined for lesions in the islets of Langerhans. Viral cytopathology was found in 4 of 7 cases of Coxsackievirus B infection, 20 of 45 cases of cytomegalovirus infection, 2 of 14 cases of varicella-zoster infection, and 2 of 45 cases of congenital rubella. Destruction of beta cells and acute and chronic inflammatory infiltrates were found in islets from cases with Coxsackievirus B infections. Characteristic inclusion bodies were observed in islets from cases with cytomegalovirus and varicella-zoster infections. This survey provides further evidence that some viruses can infect and damage human beta cells.