An outbreak of E. coli was associated with attendance at the North Carolina State Fair. The fair was held between October 13 and October 23. The outbreak spread from the Kelley Building, one of the fair's permanent structures where sheep, goats and pigs were housed and judged. The cases were residents of Wake, Sampson, Cleveland, Durham, Franklin, Johnston, Orange, and Wilson counties. Eight people required hospitalization. Nineteen case-patients provided stool specimens, and 11 (44%) had laboratory confirmation of E. coli O157:H7 with matching PFGE patterns. The PFGE pattern is the eighth most common pattern in the PulseNet database and had been associated with previous foodborne outbreaks (CDC, unpublished data, 2011). The only exposure associated with illness was having visited one of the permanent structures in which sheep, goats, and pigs were housed for livestock competitions. Fair attendees were not intended to have physical contact with animals in the building; however, 25% of case-patients (three of 12) and 24% of control subjects (five of 21) who visited the building reported direct contact with animals.