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The epidemiology of E. sakazakii is poorly understood, because infection is rare and is not a reportable condition in most countries. However, incidence appears to differ by demographic group and underlying health status; infants and immunocompromised persons appear to be at higher risk of invasive infections than other persons. Among four reported adult cases of bacteremia, two had surgical procedures with complications shortly before infection, and one of these patients died despite treatment with appropriate antimicrobial agents. Another adult developed urosepsis secondary to urinary retention, and a fourth developed sepsis without an obvious source; both of these patients were treated with appropriate antimicrobial agents and survived. Standard blood, cerebrospinal fluid (CSF), urine, and tissue culture specimens can be used to diagnose E. sakazakii infection, and isolates grow well on standard nonselective media. There are no comparative studies guiding treatment options for E. sakazakii infections. However, inference from antimicrobial susceptibility studies may be useful. Thus, investigations of outbreaks have provided the most information about the epidemiology of E. sakazakii infections. A section also reviews published investigations of outbreaks of E. sakazakii disease.