Using both historical analysis and personal reminiscence, this article describes the development of injury control activities since about 1940, focusing particular attention on the rise and fall of the Public Health Service's Division of Accident Prevention. By the 1940s and 1950s, modest but useful efforts in injury control research and programming had been made. The 1960s and early 1970s then saw an explosion of new concepts, programs, and enthusiasm, but much of this soon dissipated. Since 1985 there has been a renaissance of interest and effort, and the development of a new cadre of injury control professionals. This progress is threatened, however, by both old and new problems.