Over 90% of deaths in Alaska's commercial fishing industry were due to drowning, following vessel sinkings. In the early 1990's, the U.S. Commercial Fishing Industry Vessel Safety Act required the implementation of safety measures for all fishing vessels. The purpose of our study was to examine the effectiveness of these measures in reducing the high fatality rate of Alaska's commercial fishermen. Alaska Occupational Injury Surveillance System and AlaskaTrauma Registry data were used to examine fishing fatalities and injuries. Demographic, risk factor, and incident data were analyzed for trend. During 1991-1998, there was a significant (p<0.001) (decrease in Alaskan commercial fishing deaths. Significant progress has been made in saving lives of fishermen involved in vessel sinkings. During 1991-1997, 536 fishermen suffered severe injuries (437/100,000/year). These injuries resulted from being entangled, struck or crushed by equipment (60%) and from falls (25%). Vessel sinkings still continue to occur, placing fishermen at substantial risk. Efforts toward improving vessel stability and hull integrity and avoidance of harsh weather conditions must be made to further reduce the fatality rate. The nature of non-fatal injuries reflect that modern fishing vessels are complex industrial environments posing multiple hazards. Measures are needed to prevent falls and improve equipment handling and machinery guarding.