From 1976 through 1983, 231 balloon accidents were reported in the United States, of which 88 involved powerlines. Nine powerline accidents resulted in 22 deaths, while 7 nonpowerline accidents resulted in 11 deaths. In a more recent report, 293 balloon accidents were reported, of which 110 involved powerlines. Seven of these accidents resulted in 14 deaths, while 3 nonpowerline accidents caused 6 deaths. Electrocution is rarely the cause of death in balloon accidents involving powerlines because balloon occupants usually do not come into direct contact with electrical wires. Rather, most balloon fatalities occur from blunt force injuries when balloon occupants fall or jump to the ground. Forensic pathologists examining fatal victims of hot air balloon powerline accidents should still remember that death may occur from electrocution during flight, thermal burns, or natural causes, as well as from fall- related injuries. As in all violent deaths, every effort should be made to correlate cause of death with accident circumstances. 7 references and 5 figures