The aim of this study was to examine the synergistic bactericidal effects of medium-chain fatty acids (MCFAs; caprylic, capric, and lauric acid) and organic acids (OAs; acetic, lactic, malic, and citric acid) against Escherichia coli O157:H7 and to identify their underlying mechanism(s) of action. E. coli O157:H7 was treated with MCFAs, OAs, or different combinations of MCFAs and OAs. Membrane damage and cell morphology were examined by flow cytometry and transmission electron microscopy, respectively. Combined treatment resulted in an additional log-unit reduction compared with the sum of the reductions obtained after individual treatment. For example, caprylic acid (1.0 mM, or 0.016%) and citric acid (1.0 mM, or 0.012%) alone showed negligible bactericidal effects (0.30- and 0.06-log-unit reductions, respectively); however, a marked synergistic effect (>7.15-log-unit reduction) was observed when the two were combined. Although flow cytometry and microscopic analyses of bacteria treated with individual MCFAs and OAs showed evidence of membrane disruption, the bacteria were still able to form colonies; thus, the cell damage was recoverable. In contrast, cells exposed to combined treatments showed clear membrane disintegration and/or cell death (irreversible damage). The mechanism underlying the antimicrobial effects of combined treatment with MCFAs or OAs may involve disruption of the bacterial membrane, which then facilitates the entry of other antimicrobial compounds into the cytoplasm. The main advantage of combined treatment with very low concentrations of natural antimicrobial compounds is that it is very cost-effective. Thus, this approach may be an alternative to more conventional antimicrobial treatments, such as those currently used in public health, medical centers, and the food industry.