Pepper spray is used as an incapacitant agent. Although now available for general use in the US, the health consequences of pepper spray exposures are poorly understood. This study used data from human exposure calls to poison centers in Texas to investigate the epidemiology of pepper spray exposures. During 1998-2002 there were 1,531 human exposures to pepper spray identified by the Texas poison centers. Pepper spray reports declined during the 5-y period of the study. The majority of exposures were unintentional (84%), occurred at home (68%), involved males (56%), and comprised children and adolescents (64%). Risk factors for pepper spray exposure varied by patient age. Although 85% of the pepper spray exposures were managed outside of health care facilities, 97% of exposures involved at least minimal notable clinical effects. Given the level of detectable clinical effects of this intervention and the widespread availability of these agents, there is a need for better education of the public regarding the proper use of pepper spray and the effects of its use.