The North American species of Cortinarius section Sanguinei were studied using morphological characters and ITS and RPB2 sequence data. Several type collections also were examined. Four species were identified: C. harrisonii sp. nov, C. neosanguineus sp. nov., C. sanguineus and C. sierraensis comb. nov. Of these, C. sanguineus also occurs in Europe together with C. puniceus, a fifth member of the section. Typical features of these species include ± red, fairly small basidiomata, stipe basal mycelium often with yellow to reddish yellow tints, amygdaloid to ellipsoid spores, and aniline-red lamellar trama and pileipellis hyphae when mounted in KOH. Two other species with red lamellae C. marylandensis comb. nov. and C. smithii stat. nov. & nom. nov. also are discussed.