The purpose of this article is to define autoerotic asphyxia and present the enigma as a preventable problem. Articles published between 1856 and 1994 are identified through medline, referenced citations, and expert opinion. The literature selected were those most often cited and for which the methodological assumptions could be identified. Interventional strategies determined included legislation/regulation, technology, and education. Injury and death from autoerotic asphyxia can be controlled by pre-event, event, and post-event phase control. However, there are formidable barriers in the way.