The dependency on carbon-based fossil energy and growing awareness of climate change issues has induced ambitious policy initiatives to promote renewable energy sources for indoor heating. Combustion of regionally available material such as wood is considered a carbon-neutral alternative for oil and gas, but unregulated revival of wood stoves may cause detrimental health effects. For the prognosis of the health impact of air pollution due to the use of wood stoves, Upper Austria served for a case study. On the basis of recent measurements of particulate matter <10 μm in aerodynamic diameter (PM10) and nitrous gases (NO(x)), we compared the air pollution attributable to present energy mix (termed scenario 1) with two alternatives: For scenario 2, we assumed replacement of light fuel oil by either fossil gas or biomass, and for scenario 3, replacement of light fuel oil by biomass only. Compared with the current exposure from scenario 1, the increased annual mean PM10 levels are estimated to lead to 101 (95% CI 56;146) and 174 (95% CI 92;257) additional deaths among 1.4 million inhabitants per year for scenarios 2 and 3, respectively. Without adequate strategies for reducing the emissions of domestic heating facilities, replacement of fossil energy sources could lead to an increased health risk.