Paediatric drownings in New South Wales during the years 1987-1990 are reviewed to document the current pattern. Over these three years we have registered 250 paediatric deaths by physical injury. Sixty-one (24%) of these deaths were by drowning. Twenty-nine of the 61 drownings (47%) occurred in domestic pools; 25 of these were in unfenced or inadequately fenced pools. Of the remaining four cases, one was associated with a chair being used to gain access and the other three remain unexplained. Thirty-three of the 61 drownings occurred in country areas; of these 10 were in pools, eight in rivers or creeks, six in boating accidents, four in the surf and three in dams. A changing trend identified by this study is the increasing percentage of drownings (44%) occurring in nominally "fenced" pools in which the fencing was not functioning because the gate was open or the fencing was in disrepair. Legislation must be supported by public education and council inspection if the full benefit of isolation fencing is to be realised. With respect to all drownings there is a continuing need for education about the dangers that bodies of water, even in the bath or a bucket, pose to young children, and the need for parents to strive for optimal supervision.