Among men who have sex with men (MSM), gonorrhea trends may reflect changes in sexual behaviors that also influence risk for human immunodeficiency virus (HIV) infection. Data from the Gonococcal Isolate Surveillance Project (GISP) were used to assess trends in gonococcal infection (GC) among MSM. For the subset of GISP sites where a substantial proportion of GC cases were in MSM, a special survey of the local areas was conducted to describe factors associated with GC in MSM. This report summarizes the results of that survey, which indicate that the number and proportion of MSM diagnosed with GC has increased in the sexually transmitted diseases (STD) clinics of several large cities in the United States.