Abstract Clostridium difficile infection (CDI) is the most frequent infectious cause of healthcare associated diarrhea. Three cases of CDI in children ages 2, 3, and 14 years occurred in the hematology/oncology ward of a children’s hospital over 48 hours. Our aim was to assess environmental contamination with C. difficile in the shared areas of this unit and determine whether person to person transmission occurred. C. difficile was recovered from 5/18 (28%) samples. We compared C. difficile isolated from each patient and the environment using pulsed field gel electrophoresis (PFGE). Results showed that none of the patient strains matched each other nor did they match strains recovered from the environment, suggesting that person to person transmission had not occurred. We found that C. difficile was prevalent in the environment throughout shared areas of a children’s hospital unit. Molecular typing to identify mechanisms of transmission is useful to appropriately devise interventions.