The year 1992 marked the 50th anniversary of one of the worst civilian disasters in American history. On November 28, 1942, fire destroyed Boston's Cocoanut Grove nightclub, killing 491 people and sending hundreds more to area hospitals. The disaster came at a unique time in the history of burn care and resulted in a number of important advances in burn treatment, including the first comprehensive descriptions of inhalation injury, improvements in topical treatment of burn wounds, resuscitation of shock, use of antibiotics, and understanding of the metabolic response to injury. In addition, the fire stimulated organization of burn care facilities, public safety legislation, and burn prevention. The history of the fire is reviewed, emphasizing its role in stimulating advances that formed some of the foundations of modern burn treatment.