Seven patients less than 2 years of age with purulent pericarditis were encountered. Four infants survived, including the first infant reported with meningococcal pericarditis. Including the present patients, 50 infants with suppurative pericarditis have been described in the literature. The overall mortality was 67%; it was 47% among patients in whom the diagnosis was made clinically. Staphylococcus aureus was the most common infecting organism, and it was responsible for the greatest number of deaths. Pulmonary infection was by far the most frequently observed associated illness, whereas purulent pericarditis occurring as a primary infection was rare. Survival from purulent pericarditis depends upon adequate pericardial drainage with antimicrobial therapy. Antibiotics alone have not been successful in the treatment of this disease.