Purpose-To evaluate the prevalence, predisposing factors, and outcomes of bacterial and fungal scleritis.Methods-We reviewed the clinical findings, therapeutic interventions, and visual outcomes of patients with suppurative scleral inflammation without preceding microbial keratitis who had microorganisms isolated from scleral scrapings. Design-Retrospective, interventional case series.Results-Of 349 patients with scleritis diagnosed from 1999 to 2009, six adults (1.7%) presented with suppurative inflammation of the anterior sclera due to Pseudomonas aeruginosa (2), Streptococcus pneumoniae (2), Staphylococcus aureus (1), or Scedosporium apiospermum (1). Each had ocular surgery of the affected eye before presentation. Intraocular extension occurred in two eyes. Following local and systemic antimicrobial therapy all improved without evisceration or enucleation, and four attained vision of 20/60 or better.Conclusions-Bacterial or fungal scleritis is an uncommon ocular infection that can belatedly follow anterior segment procedures. Antimicrobial therapy and surgical intervention can successfully control progressive suppuration and reduce vision-limiting complications.