The prevalence of pharyngeal gonorrhea was investigated in a previously unstudied population: adult patients seeking care for sore throats and other symptoms of respiratory infection in general medical practices. The complaint of sore throat accounts for at least 15 million patient visits each year in the United States. A prospective study of 239 patients in three different settings revealed prevalences of 1% (95% confidence interval of 0.1-3%) in the 192 patients with sore throats, and of zero (95% confidence interval of zero to 3.4%) in 47 patients with respiratory infection symptoms other than sore throat. The data support the position that routine pharyngeal culturing for Neisseria gonorrhoeae for patients who have sore throats is not cost-efficient.