The purpose of this study was to ascertain whether viable bacteria could be cultured from patients' case-notes. Two hundred and twenty-eight current inpatients' notes were randomly sampled using contact plates to determine total viable counts, Gram-positive organisms, Gram-negative organisms and methicillin-resistant Staphylococcus aureus (MRSA). Bacteria were grown from 227. Most were ‘environmental’, however, nine notes grew S. aureus. No Gram-negative bacteria or MRSA were isolated. These results show that potentially pathogenic bacteria can be found on case notes and could act as a source of transmission or cross-infection to patients. We recommend that handwashing should occur after handling case notes before patient contact.