We reviewed 116 cases of acute hematogenous osteomyelitis (AHO) (without septic joints) from 1979 to 1985 to establish current patterns of clinical presentation, modes of treatment, and success of therapy. We found that patients present early in the course of their disease, and many have no findings other than local tenderness and an elevated sedimentation rate. Sixty-four of the patients were treated nonoperatively. The average antibiotic treatment time was 2 weeks by intravenous (i.v.) administration followed by additional outpatient oral therapy for periods of up to 4 weeks. This treatment regimen applied specifically to acute osteomyelitis led to no known treatment failures.