Since the early 1990s, Sclerotinia stem rot, caused by Sclerotinia sclerotiorum, has caused considerable damage to soybean production in the north-central United States. To determine the extent of its distribution and associated factors, investigations were conducted in 1995 and 1996 in Illinois, Iowa, Minnesota, Missouri, and Ohio. Investigations also were conducted in 1997 and 1998 in Iowa, Minnesota, and Missouri. In each state, soybean fields were randomly selected in collaboration with the National Agricultural Statistics Service. From each field, 20 soybean stems 20 cm long (from the base) in 1995 and 1996 and full-length stems in 1997 and 1998 were sampled in a zigzag pattern. During the 4-year period, stem samples were collected from 1,983 fields and assessed for the presence or absence of the disease. Of the five states, Sclerotinia stem rot was most prevalent in north-central Iowa and southern Minnesota. Sclerotinia stem rot was not detected in Missouri during the 4-year investigation period. The disease was most prevalent in 1996 and least prevalent in 1995. The prevalence of the disease was strongly related to cumulative departures from normal maximum and minimum temperatures in July and August. The disease was more prevalent when yearly temperatures were below normal than when they were above normal. In 1996, a year with a cooler-than-normal summer, the disease was detected farther south than in 1995. In both years, the prevalence of the disease was exponentially related to latitudinal positions of the fields (R2 = 0.93 and 0.83 for 1995 and 1996, respectively) reflecting the effect of the north-south variations in temperature. During the 4-year period, there was no relationship between precipitation and the prevalence of the disease. The lack of relationship may suggest that there was no shortage of moisture since it is one of the primary factors for disease development. The prevalence of Sclerotinia stem rot was less in no-till than in minimum-till or conventional-till fields (P = 0.001 and 0.007, respectively) and greater in minimum-till than in conventional-till fields (P = 0.07). Fields that had Sclerotinia stem rot, however, did not differ in incidence of the disease regardless of the tillage system.