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Beginning in 2000 and continuing into 2004, a previously undescribed disease caused significant damage to romaine lettuce (Lactuca sativa) in the coastal Salinas Valley of California. Symptoms were brownish black, sunken cavities on the crown and upper taproot. Cavities were firm, lacked signs of fungal growth, and resulted in cracking and weakening of the crown. Affected plants were stunted, uneven in growth, and unmarketable. Crisphead lettuce also developed these symptoms, although disease incidence was always lower than that for romaine. A fungus was consistently isolated from cavities. Using morphological features and molecular methods, the fungus was identified as Phoma exigua. Pathogenicity of isolates from romaine and crisphead lettuce was demonstrated on both of these lettuce types. Replicated field studies showed that azoxystrobin, boscalid, and cyprodinil + fludioxonil fungicides effectively controlled the disease. This is the first report of a crown disease caused by P. exigua in the United States. A similar disease, Phoma basal rot on greenhouse grown lettuce in the United Kingdom, had been previously observed, but no report has been published.