Child care settings have been associated with the increased transmission of many infectious agents. Respiratory tract and enteric pathogens are the most frequent cause of infections in child care. Streptococcus pyogenes and Streptococcus pneumoniae have recently gained attention, especially in association with invasive disease and antibiotic resistance. Current strategies for the prevention and treatment of infections in child care facilities include personal and environmental hygiene, immunization, exclusion or cohorting of ill children, and the judicious use of antibiotic therapy.