To describe the pattern of infective endocarditis in a tertiary hospital in Riyadh, Saudi Arabia, a retrospective review was made of all cases admitted between 1993 and 2003. Of 47 patients, a native valve was involved in 37 (78.7%) and a prosthetic valve in 10 (21.3%). Predisposing cardiac conditions were present in 27 patients: rheumatic and congenital heart disease were the most common. Blood cultures were positive in 76.4% of patients: the most commonly isolated organisms were Staphylococcus spp. in 20 patients (12 Sta. aureus and 8 coagulase-negative staphylococci) and Enterococcus spp. (6 patients). The complication rate was 78.7% and hospital mortality rate was 8.5%.