Tinea capitis is a highly contagious disorder occurring predominantly in children. Presentation is variable and, as such, mycologic confirmation of dermatophyte infection would be useful in targeting specific therapy and implementing preventive measures to interrupt spread of infection. This retrospective study was performed at an outpatient dermatology clinic in Jackson, Mississippi, over a 15-year period (1983-1998). Dermatophyte infections were confirmed using scalp scrapings cultured on Mycosel Agar containing cycloheximide and chloramphenicol. Cultures were performed on 1220 patients of all ages presenting with signs and symptoms suggestive of tinea capitis. Of the total patients meeting the inclusion criteria, 66% were younger than 13 years. Overall, 39% (478/1220) had positive cultures for dermatophytes, with black individuals having the highest percentage of positive cultures (87% [414/478]). In addition to a review of findings, we examine the impact of a cultural diagnosis of dermatophyte infection on the treatment and prevention of this highly contagious infection.