The hypertonic and aerobic culture media in the BACTEC system were compared for the detection of Haemophilus influenzae bacteremia in children. Of 1,611 blood cultures, 30 were positive for this pathogen. The aerobic and hypertonic media gave positive results in 28 and 29 cultures, respectively. Within the first 12 h, H. influenzae was detected in the hypertonic medium in 48.5% of the positive cultures as compared to 35% for the aerobic medium. Importantly, after the first 12 h, the hypertonic medium yielded positive results sooner than did the aerobic medium, the difference being statistically significant (P less than 0.01). The hypertonic medium yielded positive results earlier than the aerobic medium in nine cultures; the reverse was seen in only one culture. Furthermore, the aerobic medium gave negative growth index readings despite growth, as shown by microscopy and subculture, in 43% of the total cultures in contrast to only 13% for the hypertonic medium, a significant difference (P less than 0.05). Thus, the present study indicates a distinct advantage of hypertonic medium compared with aerobic medium in the automated BACTEC system for earlier detection of H. influenzae bacteremia and is recommended for those age groups in which this pathogen plays a predominant role.