All accidental gunshot fatalities in North Carolina were reviewed for the years 1976-80. There were 210 cases, of which 94 were self-inflicted and 116 were inflicted by others. Young white males predominated as victims, 31 per cent under the age of 15. Sixty-five per cent of the accidents occurred in the home and 18 per cent occurred in rural, "hunting" locations. Forty-one per cent of the cases involved shotguns, 39 per cent involved handguns, and 16 per cent, rifles. Sixteen per cent of the accidents involved children playing with guns and 14 per cent involved dropped or mishandled weapons. During the same period, there were 2,553 suicides and 2,509 homicides by firearm. Gunshot fatalities are an important American public health problem.