Epithelial cells were swabbed from the tonsillar surfaces of 5 patients with acute tonsillitis culture-positive for Streptococcus pyogenes. By using 10 nm gold particles conjugated to antiserum to S. pyogenes it was possible to trace the actual microorganisms when examined in a transmission electron microscope. The S. pyogenes bacteria, usually in pairs, were attached to the epithelial surface by their pili. The bacteria often formed a hollow in the epithelial cell surface. Coccus-shaped bacteria expressing positive affinity to immunogold-labelled antiserum were intermingled with bacteria, often rods, having no affinity whatsoever to the antiserum. With the immunocytological technique outlined in this study it is possible to study more closely cellular/bacterial adhesion mechanisms.