We examined data collected by the US Sea Turtle Stranding and Salvage Network on 4,328 green turtles (Chelonia mydas) found dead or debilitated (i.e., stranded) in the eastern half of the USA from Massachusetts to Texas during the period extending from 1980 to 1998. Fibropapillomatosis (FP) was reported only on green turtles in the southern half of Florida (south of 29°N latitude). Within this region, 22.6% (682/3,016) of the turtles had tumors. Fibropapillomatosis was more prevalent in turtles found along the western (Gulf) coast of Florida (51.9%) than in turtles found along the eastern (Atlantic) coast of Florida (11.9%) and was more prevalent in turtles found in inshore areas (38.9%) than in turtles found in offshore areas (14.6%). A high prevalence of FP corresponded to coastal waters characterized by habitat degradation and pollution, a large extent of shallow-water area, and low wave energy, supporting speculation that one or more of these factors could serve as an environmental cofactor in the expression of FP. A high prevalence of FP did not correspond to high-density green turtle assemblages. Turtles with tumors were found most commonly during the fall and winter months, and the occurrence of tumors was most common in turtles of intermediate size (40–70-cm curved carapace length). Stranded green turtles with tumors were more likely to be emaciated or entangled in fishing line and less likely to have propeller wounds than were stranded green turtles without tumors. Turtles with and without tumors were equally likely to show evidence of a shark attack. The percent occurrence of tumors in stranded green turtles increased from approximately 10% in the early 1980s to over 30% in the late 1990s. Fibropapillomatosis was first documented in southernmost Florida in the late 1930s and spread throughout the southern half of Florida and the Caribbean during the mid-1980s. Because green turtles living in south Florida are known to move throughout much of the Caribbean, but are not known to move to other parts of the USA or to Bermuda, the spread and current distribution of FP in the western Atlantic, Gulf of Mexico, and Caribbean can be explained by assuming FP is caused by an infectious agent that first appeared in southern Florida. Aberrant movements of captive-reared turtles or of turtles that are released into areas where they were not originally found could spread FP beyond its current distribution.