Electromagnetic fields have been suggested to contribute to the risk of depression by causing pineal dysfunction. Some epidemiologic studies have supported this possibility but have generally reported crude methods of exposure assessment and nonsystematic evaluation of depression. Using two available nationwide data sets, the authors identified from the Finnish Twin Cohort Study 12,063 persons who had answered the 21-item Beck Depression Inventory of self-rated depressive symptoms in 1990. The personal 20-year histories of exposure (i.e., distance and calculated annual average magnetic fields) before 1990 to overhead 110- to 400-kv power lines were obtained from the Finnish Transmission Line Cohort Study. The adjusted mean Beck Depression Inventory scores did not differ by exposure, providing some assurance that proximity to high-voltage transmission lines is not associated with changes within the common range of depressive symptoms. However, the risk of severe depression was increased 4.7-fold (95% confidence interval 1.70-13.3) among subjects living within 100 m of a high-voltage power line. This finding was based on small numbers. The authors recommend that attempts be made to strive for a better understanding of the exposure characteristics in relation to the onset and course of depression.