Accidental falls in 54 nursing homes with 2228 elderly residents aged 65 years and over were registered during a period of seven months. During the seven months, 512 of the elderly residents fell on a total of 934 occasions. Forty-two fractures of the neck of the femur occurred. The risk of falls for elderly residents of nursing homes is very high, but the majority of falls do not result in permanent damage. In this investigation, no differences could be demonstrated between staff groups or circumstances concerning falls with and without resultant damage. All falls should be regarded as warnings and result in detailed investigation of the circumstances of the fall in view of prophylactic measures. Accidental falls are caused by a complex interaction between a series of health, therapy, furnishing and attitudes. Various circumstances are emphasized in this investigation which are connected with an increased risk of falling, e.g. vertigo, problems of balance, certain aids and activities in connection with toileting.