In December 2021 the Minnesota Department of Health (MDH) investigated an outbreak of E. coli O143 infections linked to a sushi restaurant in the Minneapolis/St. Paul metro area. Sixteen outbreak associated cases were identified. Meal dates ranged from December 17 to December 19. In univariate analyses, three menu items/maki rolls were statistically associated with illness. All of these rolls included spicy tuna, made from ground tuna, mayonnaise, and siracha.