A majority of households in developing countries rely on biomass fuel for cooking, typically burned in open fires or simple stoves. The incomplete combustion of these fuels causes adverse health effects such as respiratory diseases, especially among women and children. However, quantitative data on pollution levels and on associated diseases are limited. We examined cooking habits and self-reported health in 31 households with outdoor open wood fires in Ouagadougou, Burkina Faso, using structured interviews. In eight households, carbon monoxide (CO) was measured using passive sampling. In addition, meteorology and ambient CO concentrations were assessed. The average CO concentration during cooking was 4.3 ppm, with a maximum of 65.3 ppm and minimum of 0.3 ppm (1-min values). A clear daily pattern was observed, with relatively low concentrations during the day and high during the evening, occasionally exceeding the World Health Organization 1- and 8-h guidelines when the air stabilised. On average, CO concentrations were 43 % higher in kitchens located in closed yards than in those located in open yards, showing that fireplace location affected the levels. Eye irritation and coughing among women and children were reported by 30 % of the households. Based on previously reported relations between CO concentrations and fine particles (<2.5 μm), the exposure to biomass smoke appears to be high enough to pose a considerable health risk among women and children in households with outdoor open wood fires. The results suggest that burning should be limited between sunset and dawn and in areas with limited ventilation to reduce pollutions levels.