The medical records of 27 patients (27 eyes) with culture-positive Staphylococcus aureus endophthalmitis, diagnosed between December 1984 and February 1992, were reviewed. In 20 of the 27 eyes, endophthalmitis occurred within seven days of ocular surgery. All tested isolates were sensitive to vancomycin, gentamicin, and ceftazidime. In 13 eyes treated by initial vitrectomy and intraocular antibiotic injection, ten eyes achieved 20/400 or better visual acuity, compared to seven of 14 eyes in the initial vitreous tap and intraocular antibiotic injection group. For the eight eyes treated initially with intraocular corticosteroids, seven eyes achieved 20/400 or better visual acuity, compared to ten of 19 eyes in the group receiving no initial intraocular corticosteroids (P = .190). The use of vitrectomy and intraocular corticosteroids with intraocular antibiotics was associated with the best visual outcomes in this group of eyes with endophthalmitis caused by S. aureus.