To evaluate the recent evolution of the European contribution to the international literature in intensive care medicine, we reviewed the source of all original articles and case reports published from 1989 to 1993 in 5 major journals: Critical Care Medicine, Intensive Care Medicine, Chest, The American Review of Respiratory Disease and Circulatory Shock. There was an overall decline in the US contributions and a corresponding increase in the European participations to Chest and the American Review of Respiratory Disease, but not to Critical Care Medicine or Circulatory Shock. The European participation to Intensive Care Medicine remained largely predominant. The evaluation of the contributions of major European countries to these 5 journals revealed a progressive increase in the French, Italian and Spanish contributions, whilst the German contribution remained stable and the UK contributions decreased. The UK contribution, which was the first in 1989, became second in 1993, after France.