Mycoplasma pneumoniae (MP) infection is associated with the emergence of anti-I cold agglutinins of IgM isotype, rarely complicated by hemolytic anemia. The mechanism by which the autoimmune disease occurs is still considerably controversed. We describe here a case of MP infection complicated by severe autoimmune hemolytic anemia with monoclonal anti-I IgM. IgM anti-I antibodies were purified by adsorption-elution on OI+ red cells. The red blood cell antibodies were found to be tightly associated with IgG and anti-MP specificity probably as immune complexes. The significance of these results is discussed.