The use of biological dressings in the treatment of burns is reviewed. Many theoretical advantages were initially proposed, but time and controlled studies have disproved some of them. Biological dressings are nevertheless helpful in relieving pain, protecting exposed vital structures, reducing exudative protein and erythrocyte loss and evaporative water loss, protecting granulation tissue, antibacterial activity, and testing a recipient bed's readiness for grafting. They probably offer no benefit in final wound debridement and primary dressings for partial thickness burns or split skin donor sites. There is no conclusive evidence that biological dressings alter epithelialization or the rate of formation of granulation tissue. A review of our last 100 cases at the Bothin Burn Center generally supports these conclusions with evidence of the superiority of homografts over heterografts.