To monitor resistance to insecticides, bioassays were performed on 102 strains of the dengue vector Aedes aegypti (L) from 16 countries ranging from Suriname in South America and through the chain of Caribbean Islands to the Bahamas, where the larvicide temephos and the adulticide malathion have been in use for 15 to 30 years. There was wide variation in the sensitivity to the larvicide in mosquito populations within and among countries. Mosquito strains in some countries such as Antigua, St.Lucia, and Tortola had consistently high resistance ratios (RR) to temephos, ranging from 5.3 to 17.7. In another group of countries- e.g., Anguilla and Curaçao - mosquitos had mixed levels of resistance to temephos (RR = 2.5-10.6), and in a third group of countries, including St.Kitts, Barbados, Jamaica, and Suriname, mosquitoes had consistently low levels of resistance to temephos (RR = 1-4.6) (P 0.05). On occasion significantly different levels of resistance were recorded from neighboring A. aegypti communities, which suggests there is little genetic exchange among populations. The impact of larval resistance expressed itself as reduced efficacy of temephos to kill mosquitoes when strains were treated in the laboratory or in the field in large container environments with recommended dosages. Although a sensitive strain continued to be completely controlled for up to 7 weeks, the most resistant strains had 24 percentage survival after the first week. By week 6,60 percentage to 75 percentage of all resistant strains of larvae were surviving the larval period. Responses to malathion in adult A. aegypti varied from a sensitive population in Suriname (RR = 1.3) to resistant strains in St.Vincent (RR = 4.4), Dominica (RR = 4.2), and Trinidad (RR = 4.0); however, resistance was generally not on the scale of that observed to temephos in the larval stages and had increased only slightly when compared to the levels that existed 3 to 4 years ago. Suggestions are made for a pesticide usage policy for the Caribbean region, with modifications for individual countries. This would be formulated based on each country's insecticide-resistance profile. Use of physical and biological control strategies would play a more critical role than the use of insecticides