Hendra virus, a novel and fatally zoonotic member of the family Paramyxoviridae, was first described in Australia in 1994. Periodic spillover from its natural host (fruit bats) results in catastrophic disease in horses and occasionally the subsequent infection of humans. Prior to 2011, 14 equine incidents involving seven human cases (four fatal) were recorded. The year 2011 saw a dramatic departure from the sporadic incidents of the previous 16 years, with a cluster of 18 incidents in a single 3-month period. The fundamental difference in 2011 was the total number of incidents, the geographic clustering, and the expanded geographic range. The 2011 cluster more than doubled the total number of incidents previously reported, and poses the possibility of a new HeV infection paradigm. Epidemiologic evidence suggests that compelling additional host and/or environmental factors were at play.