A total of eight children admitted to the Royal Hospital, Muscat with purulent pericardial effusions were analysed. Six of the cases were in children less than 2 years of age. Five of the eight children had positive blood cultures: Haemophilus influenzae was cultured from two patients, Streptococcus pneumoniae from one patient, E. coli from one patient and Streptococcus viridans from the remaining child. In three children both blood and pericardial cultures were sterile; two of these children had received prior antibiotics. In our experience early diagnosis by cross-sectional echocardiography followed by adequate surgical drainage and parenteral administration of broad spectrum antibiotics helped prevent the high morbidity and mortality usually reported in this condition in developing countries.