Cotton plants exhibiting various symptoms, including death, wilting, black sunken lesions on stems, and terminal necrosis were detected in northeastern North Carolina in mid-June of 1999. Disease incidence varied from less than 1% to more than 50% in some fields. Microscopic examination of infected stem tissue revealed the presence of the fungus Phoma exigua. Pycnidia and spores of the fungus were abundant in stem and terminal tissues.