A case of necrotizing arteritis of the coronary vessels in a 4-month-old infant is described. Death was due to thrombosis of the aneurysmally dilated coronary arteries. A review of the literature yields a total of 19 cases of necrotizing arteritis in infancy, 12 of whom showed a similar gross pathology. Of these 12 at least 8 have presented with a similar symptomatology. Etiologic theories are discussed, and suggestions are made as to the possible management of infants presenting a similar diagnostic problem.