Q fever is an important zoonosis caused by the rickettsial organism Coxiella burnetii, which can result in life threatening illness, especially in those with an underlying cardiac defect. C. burnetii infections in England and Wales reported to the PHLS Communicable Disease Surveillance Centre between 1984 and 1994 were reviewed. A total of 1117 cases were reported, a third of which came from the South Western region. The annual totals fell over this period. The mean age of cases was 45 years, and 74% were men. Reports peaked in the month of May. Contact with animals, mainly cattle and sheep, was reported in 60 cases. Occupationally acquired infection was reported for 24 cases including abattoir workers, farmers, veterinary surgeons, hide handlers, and butchers. Forty-seven per cent of cases presented with respiratory symptoms, 7% with heart disease, and 5% with hepatitis. Seven per cent of cases reported travel abroad before becoming ill. Joint veterinary and medical investigations should be undertaken to establish the natural history of C. burnetii infection in England and Wales and formulate policies to prevent acute and chronic infections.