Previous studies of the accuracy of rapid in-office tests for group A Streptococcus had disparate results, ranging from a sensitivity of 70% to more than 90%. The sensitivity and specificity of 3 commercially available Strep A tests were determined in 2 private pediatric office settings. Acceava Strep A, Genzyme OSOM Strep A, and the Quidel QuickVue Strep A tests were the representative rapid tests for detection of Streptococcus pyogenes. Overnight culture on standard 5% sheep blood agar was the reference standard for this study. All 3 Clinical Laboratory Improvement Amendments-waived tests had sensitivities and specificities that exceeded 95%.