Primary plague pneumonia occurred in a 47-year-old South Lake Tahoe woman shortly after face-to-face exposure to her plague pneumonia-infected cat. Both died. Field investigation revealed a recent plague epizootic in squirrels and chipmunks around the patient's home. Control measures included active surveillance and chemoprophylaxis of 197 contacts to the victim, a community alert on methods of self- and pet protection, and application of insecticide to reduce rodent flea populations. No secondary cases occurred.