Analysis of the radiographs of 9 infants who died of proved Group B streptococcal sepsis revealed a typical pattern of hyaline membrane disease despite birth weights of over 2,000 g in most cases. Pleural effusions subsequently developed in 6 infants; the rest had pleural fluid at postmortem examination. This is an unusual finding for either hyaline membrane disease or non-group B streptococcal sepsis in the neonate, and may have implications for the early diagnosis and treatment of this usually lethal infection.