Clues that might aid in predicting the appearance of rheumatic fever after a streptococcal pharyngitis were sought in the histories of 183 patients who had their first attack of rheumatic fever during the 24-month period ending Dec. 31, 1959. Of the 183 patients, only 84 (46%) gave a history of sore throat. It occurred in 50% of the patients who developed arthritis as the presenting feature of rheumatic fever and in 36% of those who did not. More effective treatment of streptococcal pharyngitis is urged, but additional prophylactic measures needed to be developed if rheumatic fever is to be prevented in patients who do not have a premonitory attack of sore throat.