Sources of elemental mercury (Hg0) include old natural gas regulators, manometers, sphygmomanometers, thermometers, and thermostats. Causes of Hg0 spills include improper storage, container breakage, children playing with Hg0, the breakage of devices containing Hg0, and ritualistic use of Hg0. Inhalation is the primary exposure route for Hg0. Mercury released into the environment can enter lakes and streams, where bacteria convert it into methylmercury, which bioaccumulates in fish. Chronic exposure to Hg0 vapors can damage the kidneys and neurologic system. Short-term exposure to high levels of Hg0 vapors may cause lung damage, nausea, vomiting, diarrhea, increases in blood pressure or heart rate, skin rashes, and eye irritation, among other effects. Minimizing Hg0 dispersal is important after an Hg0 spill. Tracking by shoes or apparel or vacuuming can spread Hg0, increasing airborne concentrations and cleanup costs. The Illinois Department of Public Health's response to an Hg0 spill depends on the size of the spill. Airborne concentrations after large spills are mapped with a mercury vapor analyzer (MVA). The cleanup begins with the spill site and any hot spots that were identified with the MVA. Hard surfaces can usually be cleaned, but contaminated porous items must be discarded. Leaving marginally contaminated items outdoors for a month or more during warm weather may dissipate the Hg0. After a cleanup, clearance sampling is conducted to determine if further cleanup is needed. The best way to prevent Hg0 spills is reduce its use. Key words: cleanup, elemental mercury, health effects, mercury, prevention, remediation, spill, spill management.