Acute respiratory infections (ARIs) are the most important infectious cause of death, but there is less information of their burden in the community. This study describes the burden of ARI in a cohort of 50 Iranian families visited weekly over 2 months. Eighty-one out of 113 (72%) children and 29/103 (28%) adults had a total of 124 episodes of ARI. Seventy-five per cent of the episodes occurring in children were primary/co-primary compared to 40% of those in adults (P<0.01). Children were more likely to be the first symptomatic cases and infections were frequently transmitted within the family. Frequencies were lowest among adults, low among infants aged <6 months and highest among children aged <5 years (P<0.01). Winter episodes occurred more frequently in January (P<0.01). The high frequency and apparent transmissibility of ARI in this cohort highlights its enormous burden in the community.