Organic lettuce, Lactuca sativa L., growers on the Central Coast of California rely on conservation biological control to manage Nasonovia ribisnigri Mosley (Hemiptera: Aphididae) and other aphid pests of lettuce. In 2006, we carried out five replicated field trials to determine the importance of syrphid larvae in the suppression of N. ribisnigri and other aphids infesting organic romaine lettuce. We used Entrust, a spinosad-based insecticide approved for use on organic farms, to suppress syrphid larvae in aphid-infested romaine. Romaine treated with Entrust was unmarketable at harvest because of aphid infestation, whereas insecticide-free romaine was marketable. Syrphid larvae composed 85% or more of total predators in most trials, and they were the only predators consistently recovered from romaine that was infested with aphids early and largely aphid-free by harvest. The species mix of nonsyrphid predators varied from site to site. Applications of Entrust suppressed nonsyrphid predators in two trials, and so was an imperfect tool for selectively suppressing syrphid larvae. The relative importance of syrphid larvae and other predators in the conservation biological control of aphids in organic romaine is discussed. We conclude that syrphid larvae are primarily responsible for the suppression of aphids in organic romaine on California’s Central Coast.