Marine organisms occasionally settle at exceptional densities, whereby thousands of individuals arrive concurrently. High levels of mortality, which has historically been attributed to predation or competition, often follow this episodic settlement of reef fishes. Here, however, we observed large numbers of newly settled surgeonfish (Ctenochaetus striatus) with white lesions lying dead on the sand amongst patch reefs following separate episodic settlement events in 2006 and 2009 in Moorea, French Polynesia. Pathogens have been identified as an important driver of population dynamics in other marine organisms but less so for reef fishes. Our observations suggest that disease outbreaks may play an underappreciated role as a mechanism of mortality following episodic settlement events in reef fishes.