A review of 19 consecutive serious bathtub immersion accidents (11 survivals, 8 fatalities) is presented. In all instances, consciousness was lost in the water. Unlike other childhood accidents which usually show a male predominance, the sexes are equally affected. The modal age is 11 months. Six separate causes of bath drownings and near-drownings have been identified, and in 14 of the 19 accidents, two or more causes were operating concurrently. Median estimated immersion time for survivals was four minutes, and five minutes for fatalities. The median depth of water was eight inches. An 'at risk' profile for home bathtub drownings is presented; this includes the youngest or second youngest child of a large family, a family of grade 4 to 7 sociooccupational status (congalton) and a family in which routine is temporarily broken.