Patients with culture-proven infections with Neisseria gonorrhoeae or Chlamydia trachomatis, or both, seen at the Olmsted County Health Department Sexually Transmitted Disease Clinic were evaluated for the presence of dysuria and exudate. Eighty-four patients (21%) had neither symptom. N. gonorrhoeae infection alone was most frequent (47%), but C. trachomatis predominated in men. Dysuria was most often detected in men infected with C. trachomatis, but exudate was most frequently found in men infected with N. gonorrhoeae alone or in mixed infections with C. trachomatis. The presence of both symptoms was more common in men than in women infected with N. gonorrhoeae or C. trachomatis. However, as the occurrence of dysuria and exudate was generally similar within the male and female groups, regardless of the organisms recovered, the type of infection cannot be accurately determined on the basis of symptomatology alone. The authors therefore believe that the diagnosis of genital infection by C. trachomatis or N. gonorrhoeae, or both, by culture technics is essential because effective treatment with antimicrobial therapy often requires this information.