The carrier state in foot and mouth disease (FMD) is characterized by the asymptomatic low-level excretion of foot and mouth disease virus (FMDV) from the oropharynx of ruminants for periods that are species and virus strain-dependent. Persistent infection with FMDV readily occurs following the failure of virus elimination at the acute stage of infection, a process thought to be mediated through the phagocytosis of antibody/virus immune complexes. Recent evidence supports the view that carrier cattle are important in the epidemiology of FMD in the field. The absence of histopathological change in persistently infected tissues and the reduced cytopathology of carrier virus isolates in tissue culture suggest that less lytic FMDV variants are generated or selected in the carrier animal. Altered virus replication, due to attenuation or interference, rather than antigenic variation may therefore allow evasion of the exaggerated FMDV-specific systemic and local humoral immune responses that occur in the carrier state. Although cell-mediated immune mechanisms for FMDV clearance have not been described, the eventual elimination of many persistent virus infections involves this arm of the immune system. Thus, further investigation of cellular elements of the immune response, more particularly the local interaction of mononuclear cell infiltrates with persistently infected cells, represents an area of research that has the potential to elucidate the carrier state problem.