# Nuclear terrorism {#article-title-2} Three members of International Physicians for the Prevention of Nuclear War and Physicians for Social Responsibility discuss the threat of nuclear terrorism and conclude that the only effective way to tackle it is to abolish nuclear weapons The attack on the World Trade Center in New York clearly showed that there are terrorists who are willing to inflict civilian casualties on the scale that would be expected with the use of a weapon of mass destruction. In this article we consider the form that nuclear terrorism could take and estimate the casualties that would occur if a nuclear bomb the size of that dropped on Hiroshima was detonated in a large urban area. The enormous casualties to be expected from such an attack argue strongly for a strategy of primary prevention. #### Summary points In the aftermath of 11 September 2001 nuclear terrorism has emerged as a real threat Nuclear terrorism could take several forms, from an attack on nuclear power plants and reactors to the detonation of a nuclear bomb in an urban area The international community urgently needs to expand its efforts to secure existing stockpiles of nuclear weapons and materials, particularly in Russia, Pakistan, and India The elimination of nuclear weapons should be high on the global public health agenda Nuclear terrorism might take several forms. An attack on a nuclear power plant or other nuclear installation could result in a massive release of radioactive material. Despite initial statements by the US Nuclear Regulatory Commission that commercial power plants could withstand an aircraft crashing into them, it seems likely these plants are highly vulnerable. As early as 1982 a study by the Argonne National Laboratory of the US Department of Energy found that, if a jet aircraft crashed into a nuclear reactor and only 1% of its fuel ignited after … Correspondence to: Z A Bhutta