This case-control study sought to determine whether protection against clinically significant rotavirus diarrhea in children aged 4–35 months correlated with titers of serum neutralizing antibody and, if so, whether this protection wasserotype-specific. Titers of acute-phase sera from 156 cases of treated rotavirus diarrhea in rural Bangladesh were contrasted with titers from 312 contemporaneously selected, age-matched controls. Analyses of the culture-adapted rotaviruses from the cases revealed that 24%,15%,43%, and 17% belonged to serotypes 1–4, respectively. Titers of both homologous and heterologous neutralizing antibody in acute blood specimens of cases were significantly lower than those of matched controls. However, multivariate logistic regression modelsdemonstrated that only antibodytiters to heterotypic rotaviruseswereindependently associated with protection against rotavirus disease. These data, which indicate that the correlation of protection with neutralizing antibody titers is not serotype-specific, suggest that immunity to rotavirus disease may be mediated by other factors.