A postal survey assessed the role of home mechanical ventilators (HMV) in the management of chronic respiratory failure in the Irish Republic. The survey collected information on indications for therapy, investigations performed and patient follow-up. Surveys were sent to all centres identified as prescribing HMV and were completed by February 2002, relating to the situation existing on July 1st 2001. From a total of 52 preliminary surveys, 14 centres (including two paediatric) were identified as prescribing HMV. A total of 157 patients used HMV and 67 (43%) were initiated on HMV during the 12 months prior to the survey. There were more males than females (86[55%] v 71[45%]) and most (61%) were in the 25-65 age bracket. The causes of respiratory failure were lung diseases (41%), thoracic cage deformities (33%), and neuromuscular diseases (26%). The majority of HMV users (95%) were prescribed pressure-cycled ventilators. The survey identified inadequate procedures for follow-up of patients on HMV and an over-reliance on equipment suppliers for patient support.