Four flocks of the Nicholas strain and two of the British United turkey (BUT) strain of large white market turkey toms were monitored from 8 to 19 weeks of age to identify the presence, incidence, age distribution, and possible cause(s) of perirenal hemorrhage syndrome (PHS), or acute hypertensive angiopathy. Mortality rates varied among the flocks from 0.81% to 1.78% of total poults started. Nicholas flocks has a distinct peak in mortality between 9 and 14 weeks of age. PHS was the main cause of mortality from 8 to 14 weeks of age in all flocks except one, and the incidence diminished after 15 weeks of age. No significant bacterial pathogens were detected in any of the PHS cases. Distinct peaks in overall weekly mortality between 10 and 13 weeks of age similar to those in the four Nicholas flocks were also observed in six of 10 Minnesota flocks surveyed separately.