The incidence of pediculosis infestation is greater than that for all childhood communicable diseases combined. Each year approximately 6 to 12 million persons become infested, resulting in an estimated cost of $367 million to manage the problem. Pediatric health care providers are often confused regarding proper management of head lice because of the multitude of manufacturer claims in the competitive advertising market. This comparative study was designed to evaluate the combined efficacy of seven pediculicidal agents with their supplied nit removal combs in the treatment of head lice. A sample of children (n = 223) was studied from 4271 children screened at various elementary schools throughout Florida. The results of this study can assist school health care providers and pediatric nurse practitioners in identifying the most effective nit removal comb and those children at risk for head lice infestations.