BACKGROUND Respiratory syncytial virus (RSV) is the major viral pathogen causing lower respiratory tract infection in young children. Early detection allows cohorting of infected inpatients to prevent nosocomial transmission and consideration of treatment. To achieve rapid reporting, antigen detection has been widely used. Since late 2002, the FDA approved two new RSV antigen detection tests, the Now RSV test (Binax) and the Directigen EZ RSV (Becton Dickinson), both of which promised reduced hands-on processing. OBJECTIVE Evaluate relative performance of the two new rapid antigen detection assays. METHODS To compare the performance of these newer tests with a previously existing antigen detection test (Becton Dickinson) and shell vial viral culture with clinical specimens. CONCLUSIONS A total of 89 fresh respiratory specimens from 84 pediatric patients were tested. We also performed reverse transcription-polymerase chain reaction (RT-PCR) on all culture negative but antigen positive samples as well as 26 specimens that were negative on both shell vial culture and antigen testings. Overall, the three antigen assays performed similarly well. The hands-on processing for the two newer tests was significantly reduced, making them more convenient for rapid screening.