The accuracy of presumptive criteria for identification of Neisseria gonorrhoeae was assessed in two separate populations of women with a low prevalence of gonorrhea. Of the presumptively positive cervical isolates available for confirmation, 98.5% were identified as N. gonorrhoeae. Of 25 isolates that could not be confirmed, 20 failed to grow on subculture, and of the remaining 5, only 2 (0.6% of all viable recoveries) were identified as nongonococcal isolates (N. meningitidis). Our study confirms earlier findings that meningococcal isolates are rarely found in endocervical specimens. The benefits from early treatment and counselling of women for gonorrhea on the basis of presumptive criteria outweight the risks occasioned by the rarely encountered nongonococcal isolate.