Due to variations in the thickness of U.S. coal seams, there is great variability in the height of the roof where underground miners work. Restrictions imposed by low seam heights have important safety consequences. As the height of their workplace decreases, miners must stoop, duck walk, or crawl, and their vision, posture, and mobility become increasingly restricted. Low seam height also places important restrictions on the design of mobile equipment and other mining machinery. Using the employment and injury data reported to the Mine Safety and Health Administration (MSHA) from 1990 to 1996, small underground bituminous coal mines with less than 50 employees were stratified by average coal seam height according to the following categories: low (< or =42"), medium (43"-60"), and high (> or =61"). Injury rates for both nonfatal days lost and fatality cases were examined by seam height and leading type of injury incidents. The leading types of incidents associated with fatalities were roof falls and powered haulage equipment. In comparison to high-seam mines, miners working in low or medium seams are at higher risk of being killed by powered haulage equipment, roof bolting machines, and falls of unsupported roof. The leading types of incidents associated with nonfatal injuries were handling materials and powered haulage. As mining height decreases, miners are at increasingly higher risk of having a nonfatal injury from incidents involving roof bolting machines, load-haul-dump equipment, personnel carriers, and powered haulage conveyors. As mining height increases, miners are at increasingly higher risk of having a nonfatal injury from slips and falls and incidents involving shuttle cars and roof and rib falls. Knee injuries are a particularly severe problem in low-seam mines. The rate of injuries to miners while crawling or kneeling is 10 times higher in low seams than in high seams.