In 2011, an E. coli O104:H4 outbreak in Europe that was eventually attributed to the consumption of fenugreek sprouts grown at a farm in Germany was impressive in terms of its devastation. Primary cases were associated with sprout consumption; secondary transmission was also documented. The E. coli outbreak resulted in 4321 cases, an unknown number of hospitalizations, at least 908 instances of hemolytic uremic syndrome, and at least 50 deaths. Cases were reported throughout the European Union and the United States. Five of the six cases residing in the United States had recently traveled to Germany; the sixth case had contact with one of the other cases. The fenugreek sprout seeds had been imported into the European Union from Egypt.