Falls in institutional settings have been associated with considerable morbidity. Although risk factors for falls have been described for acute care and geriatric settings, data from the rehabilitation setting are sparse. To provide a descriptive epidemiology, incident reports of falls were reviewed at a 151-bed rehabilitation facility. Of 567 patients admitted between January 1 and December 31, 1984, 71 (12.5%) experienced at least one fall; most (75%) of the falls occurred in patients using wheelchairs. Risk for falls was associated with increasing age (p less than 0.05), a diagnosis of stroke, or lower extremity amputation (p less than 0.05). Of the 71 fallers, 31% experienced repeat falls which tended to occur more frequently with older age, disorientation, and nonambulatory status at first fall. Nearly 13% sustained injuries, which tended to occur more frequently among disoriented and wheelchair or bedfast patients. These data suggest that groups of patients who are at high risk for falls within the rehabilitation setting can be identified for the purposes of prevention, and targeted for preventive measures.