Two hundred and ten histologically diagnosed cases of mycetoma filed in the Departments of Pathology of four Medical Colleges in Tamil Nadu, India, between 1964-1987 were subjected to detailed histopathological study; Actinomadura madurae, was found in 73 of them. In nine cases of mycetoma pedis, the organism A. madurae has been isolated in pure culture. In one case, the lesions were present in both the feet. The characteristic cream-coloured granules were seen in all. The lesions responded well to a combination of Streptomycin and dapsone.