Objective.—Avalanches pose a life-threatening risk to participants of outdoor winter activities. Determining the causes of death in avalanche fatalities can aid rescue and resuscitation strategies and hopefully improve survival.

Methods.—The study population included all avalanche fatalities in Utah from the 1989–90 to 2005–06 winter seasons. The Utah Avalanche Center and Medical Examiner records were reviewed to identify accident circumstances, autopsy findings, and causes of death.

Results.—Fifty-six avalanche deaths were identified during the study period. Most deaths occurred while participating in recreational backcountry activities; 85.7% of deaths were due to asphyxiation, 8.9% were due to a combination of asphyxiation and trauma, and 5.4% were due to trauma alone. Head injuries were frequent in those killed solely by trauma.

Conclusions.—Most avalanche deaths in Utah result from asphyxia. Therefore, most victims are alive in the postavalanche period and have the potential for live recovery. Rescue strategies that employ rapid recovery as well as techniques that prolong survival while buried provide the best means of improving outcome.