Among patients with disseminated gonococcal infection and pustular skin lesions, Neisseria gonorrhoeae was identified in exudates from the skin lesions by the direct fluorescent antibody test in 57%, by gram stain in 11%, and by culture in only 9%. However, gonococci were cultured from four of seven pustular biopsies of skin lesions. Gonococci were also identified by fluorescent antibody examination in four of eight buffy coat smears from patients with negative blood cultures, but in only one of eight culture-negative synovial fluids. Among patients without disseminated gonococcal infection, smears of synovial fluid, buffy coat, and exudate from skin pustules were uniformly negative by the fluorescent antibody test. This test has contributed to studies of the pathogenesis of disseminated gonococcal infection and is frequently useful in the diagnosis of this condition.