The number and properties of drug-resistant coliform bacteria in hospital and city sewage were compared. There was little difference in the counts of organisms with nontransferable resistance to one or more of 13 commonly used drugs. An average of 26% of coliforms in hospital waste water had transferable resistance to at least one of the drugs ampicillin, chloramphenicol, streptomycin, sulfonamide, or tetracycline as compared to an average of 4% in city sewage. R + bacteria in the hospital discharge were also resistant to a broader spectrum of drugs than those in city sewage. In both effluents, the occurrence of fecal Escherichia coli among R + coliforms was twice as high as among coliforms with nontransferable resistance. Resistance was transferable to Salmonella typhi , and such drug-resistant pathogens in the water environment could be of particular concern. The significance of the results with regard to environmental pollution with R + bacteria and the dissemination of these organisms is discussed.