Total protein-bound sialic acid content was determined in normal and pathological human serum with special reference to the C-reactive protein test. Almost all of the serum positive for C-reactive protein had high sialic acid levels. It is likely that different pathological processes may account for the appearance of C-reactive protein and increase in the serum sialic acid level. Nevertheless, it is believed that determination of the level of serum sialic acid should prove a useful adjunct to the diagnosis of rheumatic fever and related diseases. The C-reactive protein itself did not contain sialic acid.