From August 22 to November 6, 1981, 989 cases of acute hemorrhagic conjunctivitis were identified in Key West, Florida. The outbreak probably began when an infected 12-year-old Key West resident returned from the Bahamas and transmitted the illness to several neighborhood playmates. The rate of illness was highest for school-aged children, and a high proportion of cases occurred among blacks living in two adjacent low-income housing tracts. A telephone survey of persons living in these two tracts showed that the risk for introduction of illness into a household was 3.8 times greater for families with school-aged children. A study of 100 case households showed that black race, living in the two low-income housing tracts, and having a high ratio of family members per bathroom were variables significantly associated with multiple case households. To limit intracommunity spread of illness, symptomatic children were excluded from school for a period of seven days. The number of reported cases steadily decreased after school exclusion was implemented.