Almond leaf scorch (ALS) disease has emerged as a serious threat to almond (Prunus amygdalus) production areas throughout California's San Joaquin Valley. This disease is caused by the xylem-limited bacterium Xylella fastidiosa, and this pathogen is transmitted by xylophagotts insects including sharpshooter leafhoppers (Hemiptera: Cicadellidae) and spittlebugs (Hemiptera: Cercopidae). Among four orchards surveyed, enzyme-linked immunosorbent assay (ELISA) and bacterial isolation followed by polymerase chain reaction (PCR) were equally effective in detecting X. fastidiosa from ALS-symptomatic trees. Disease incidence varied among almond cultivars in each orchard, with the highest mean incidence and most severe symptoms frequently encountered in 'Sonora'. X. fastidiosa isolates consisted of mixtures of grape or "G-genotype" and almond or "A-genotype" strains present in surveyed orchards. The X. fastidiosa G-genotypes characterized from each orchard were associated with the most severely affected 'Sonora' trees in three of the four orchards. Both ordinary runs and simple randomization analyses revealed aggregations of ALS in three of the four orchards. Clusters of ALS-affected trees frequently occurred in the outermost orchard rows. Plots of semivariance in ALS incidence over distance varied in shape and magnitude among cultivars. Setnivariance increased over distance in 'Sonora' and 'Carmel', indicating spatial dependence or aggregations of incidence best fit by a combination of spherical and linear models. These results document both random and aggregate patterns of ALS spatial distribution in selected orchards and further illustrate how cultivar susceptibility influences the distribution patterns of ALS incidence. Following the recent introduction and establishment of the glassy-winged sharpshooter, Homalodisca Coagulata, the impact upon the epidemiology and spread of ALS is unknown.