The decade of the 1970s was marked by an increased survival of children with complex heart lesions, use of prosthetic material in open heart surgery, and placement of indwelling central catheters in critically ill patients. We analyzed all 26 cases of children with infective endocarditis (IE) seen at Yale University, New Haven, Conn, from 1970 through 1979 to determine whether these and other factors resulted in a change in pediatric IE. A larger proportion of cases arose postoperatively as compared with previous series. Among the postsurgical and catheterization-related cases, the most common infecting agents were streptococci, not the expected staphylococci. Although the number of cases was small, IE associated with prosthetic material had a favorable prognosis; all survivors of IE with prosthetic material were cured by medical regimens alone. The IE cases in children with previously normal hearts were associated with indwelling central catheters.