Neisseria meningitidis Group Y has been considered to be an uncommon pathogen in children. We reviewed the cases of Group Y meningococcal disease in children managed at our institution from 1974 through 1982. Twenty-four percent (6 of 25 cases) of the meningococcal disease in children between 5 and 20 years of age was caused by N. meningitidis Group Y. This serogroup of meningococcus was not isolated from children younger than 5 years of age. Meningococcemia characterized by purpura fulminans was the most common presentation. Pneumonia, a common presentation of Group Y meningococcal disease in military recruits, was not observed. Group Y meningococcal disease had emerged as a cause of meningococcemia and meningitis in older children and adolescents.