We reviewed fatal injuries in Fulton County, Georgia, in collaboration with the medical examiner's office. This county encompasses most of the city of Atlanta and has a population of approximately 600,000 persons. Information collected for 1981 and 1982 was analyzed; and the results of blood alcohol content (BAC) testing and toxic screens were reviewed for all victims of homicide, suicide, and unintentional fatal injuries who died within six hours of being injured. Seventy-one percent of 271 homicide victims had been drinking, and 51 percent had BACs greater than or equal to 0.1 mg/dL. Of 153 suicide victims, 37 percent had been drinking and 20 percent had BACs greater than or equal to 0.1 mg/dL. Of 54 drivers who died in single-vehicle collisions, 78 percent had been drinking; 54 percent of 162 victims of nonvehicular unintentional fatal injuries had positive blood alcohol levels. There was little evidence of the use of psychotropic drugs among victims of fatal injury. Most of the victims of homicide and unintentional fatal injuries who had positive toxic screens also had a positive blood alcohol tests.