House depressurization occurs when household equipment such as a kitchen or bathroom fan or a fireplace exhausts air from the house and lowers the pressure indoors with respect to the outside. The operation of air handlers for forced-air heating or cooling systems also can have a depressurization effect. This depressurization can hinder the natural draft from vented combustion appliances and lead to backdrafting, which in turn can result in combustion gases spilling into the indoor airspace. Extensive spillage can cause elevated indoor levels of combustion products such as carbon dioxide (CO2) and water vapor, as well as contaminants such as carbon monoxide (CO) and nitrogen dioxide (NO2). The focus of this paper is to review studies on depressurization-induced backdrafting and spillage from gas-fired, drafthood equipped furnaces and domestic hot water heaters. Qualitative and quantitative techniques that were used in depressurization and backdrafting studies conducted in Canada, Europe, and the United States are analyzed. These studies have shown that exhaust fans operated simultaneously with fireplaces depressurize houses by 3 to 8 Pa on average. The CO indoor concentrations due to spillage, as reported in these studies, generally have been lower than 5 ppm. However, such low CO concentrations do not necessarily imply that a potential problem associated with backdrafting does not exist. Other combustion products, such as NO2, rarely have been measured in prior backdrafting studies. It can be concluded from the literature review that causes of house depressurization are well understood. However, more comprehensive research is needed to better understand the frequency, duration, and severity of depressurization-induced spillage in a broad cross section of houses. Efforts in this direction have begun recently in the United States through a workshop to define research issues, pilot studies to develop comprehensive measurement protocols, and consensus standard development activities to prepare standardized methods and protocols.