Tetanus causes approximately 50,000 deaths per year worldwide, the incidence being greatest in undeveloped countries. Once tetanus occurs, the risk of death is substantial. Physician attention to the immunization status of patients who present with wounds, chronic and minor, can improve prevention of tetanus. It should be noted that more than 10% of the US population is not properly immunized against tetanus and that those at greatest risk are females of any age, males older than 50, blacks from the rural South, and those without any military experience.