The Fourth International Kawasaki Disease Symposium was held during the past year, and this and other forums have stimulated continued interest in this idiopathic vasculitis of childhood. Considerable epidemiologic evidence supports an infectious etiology for Kawasaki disease, but molecular approaches to its identification remain unrewarding. Bacterial toxins functioning as possible superantigens, retroviruses, and Epstein-Barr virus are among the candidate “Kawasaki agents” currently being investigated. Other researchers are attempting to gain insight into the illness through the use of sophisticated epidemiologic techniques, by identifying the cytokines characteristic of acute Kawasaki disease, or through a potential new animal model. At the same time, clinical management of acute Kawasaki disease is being refined as a result of new information concerning the optimal use of both salicylates and intravenous gamma globulin.