We extracted data from the Medical Examiner's files for all fire deaths in Alberta reported to the Medical Examiner's for the period 1985-1990. Of the 320 fire deaths, 183 (57%) were unintentional deaths from house fires. The highest house fire death rates occurred in children 0-4 years and in adults > or = 80 years of age (2.9 and 3.2 per 100,000 per year). The majority (53%) of fatal house fires occurred in single detached dwellings but the rate of fatal house fires was 9.0 times higher in moveable dwellings than in single detached dwellings. At least 61 (33%) of unintentional fatal house fires were caused by smokers' material. Blood alcohol levels above 0.8 g/L were found in 84 (59%) of victims tested and in 39 (76%) of victims of fires caused by smoking materials. 143 (78%) house fire deaths were due, at least in part, to inhalation of toxic fumes. The cause of fatal house fires in Alberta is multifactorial. However, particular attention should be paid towards the lethal combination of cigarettes and alcohol in preventing these fires.