Post-streptococcal complications such as acute rheumatic fever (ARF) are reportedrnto be common among Ethiopian children. Little is known, however, about the epidemiology ofrnb-hemolytic streptococci, and Group A streptococci (GAS) in Ethiopia. A total of 937rnrandomly selected healthy schoolchildren residing in Addis Ababa (n=491), Gondar (n=265)rnand Dire-Dawa (n=181) were studied during a period November 2004 and January 2005.rnThroat specimens were collected and b-hemolytic streptococci were isolated on Columbiarnblood agar supplemented with Colistin-oxolonic acid. Gram reaction, catalase test Bacitracinrnsusceptibility test and serological test were used to differentiate the organisms. In additionrnbiochemical testing (API) was used to identify the species of isolates that could not bernserogrouped.rnGAS were the predominant b-hemolytic streptococci with a proportion of 55% inrnAddis Ababa, 61% in Gondar, and 47% in Dire-Dawa of the serogroups. The carrier rate ofrnGAS in healthy schoolchildren was 10.8% in Addis Ababa, 8.7% in Gondar and 9.4% in Dire-rnDawa. Seven isolates that were nongroupable confirmed to be Streptococcus constellatus withrnAPI biochemical testing. Molecular (emm gene) typing was performed on 82 GAS isolates andrn44 different emm types were detected. Among the 82 isolates 18 strains belonged to 13 new,rnpreviously undescribed emm subtypes. Known rheumatogenic strains accounted for 56% ofrnisolates in Addis Ababa, 35% in Gondar and 0% in Dire-Dawa.rnOf the emm types prevalent in the study communities, 60% were not included in thern26 valent vaccine that was formulated for western countries. The distribution of emm typesrndescribed in this study was compared with the study conducted on isolates collected 13 yearsrnago in Addis Ababa, only 3/20 emm types identified in earlier study had been represented inrnthe present study. Moreover, the type, which was predominant in the previous study, was notrndetected in the current one and the type that was predominant in our study was not detected inrnthe previous one.rnxrnIn conclusion, Group A was the most frequent serogroup among b-hemolyticrnstreptococci isolated from throat swabs of healthy schoolchildren in the selected three sites ofrnEthiopia and the carriage rate of GAS ranged from 8.7 to 10.8%. Tremendous diversity ofrnemm types was observed in this first large scale emm type survey in Africa, and a significantrnproportion of them are known to be rheumatogenic. The association of the prevalent emmrntypes not previously linked to rheumatic fever needs to be explored particularly in Dire-Dawa.rnKey Words: Beta-hemolytic streptococci, Group A Streptococci, Streptococcus pyogenes,rnM protein, emm typing