Ground falls (roof and rib) have historically been responsible for nearly 50% of all fatalities in bituminous underground coal mines. In recent years, the number of some annual ground fall fatalities has approached zero, indicating that significant progress has been made. On the other hand, the twin disasters at Crandall Canyon in 2007, in which nine miners perished in violent coal bumps, provided a stark reminder that complacency is premature. One important success has been a great reduction in the number of miners killed inby roof supports. Throughout the 1990s, these accounted for nearly half of all roof fall fatalities, but there have just been two inby incidents since 2005. Progress has also been made in pillar recovery, where there has been just one fatal incident since 2005. On the other hand, more than 300 miners continue to be injured each year by rock falling from between supports and 100 more are injured by rib falls. Together, these two categories also account for a large percentage of recent ground fall fatalities. Available technologies such as roof screen, rib bolting and inside control roof bolters could reduce injury and fatality rates if they were used more widely. Further advances in these areas will likely be the next big advance in ground control safety.