One hundred forty-nine mothers and 74 fathers of infants who presented at the Special Treatment Clinic (Nairobi) with ophthalmia neonatorum were evaluated. Neisseria gonorrhoeae was isolated from 60 (40%) of 149 mothers and Chlamydia trachomatis was isolated from 31 (21%). Twenty-six mothers (17.5%) had clinical evidence of endometritis or pelvic inflammatory disease. Mothers with endometritis and/or pelvic inflammatory disease were more often infected with N. gonorrhoeae (65%) than were mothers without these conditions (24%) (P less than or equal to .001). N. gonorrhoeae was isolated from ten (14%) and C. trachomatis from three (9%) of 32 fathers, and nongonococcal urethritis was diagnosed in an additional 21 fathers (28%). Seven of ten men with gonococcal urethritis and 18 of 21 with nongonococcal urethritis had no symptoms. These data confirm that the presence of ophthalmia neonatorum in a neonate should be considered as a strong indicator of sexually transmitted disease in the parents. Although most infections in fathers were asymptomatic, the mothers were at high risk for complications.