Legislation in North Carolina has mandated obtaining renewable energy from the incineration of poultry waste, resulting in proposals for three poultry-litter-fueled power plants statewide. This article summarizes environmental health and environmental justice issues associated with incineration of poultry waste for the generation of electric power. Emissions from poultry waste incineration include particulate matter, dioxins, arsenic, bioaerosols and other toxins; various components are associated with cardiovascular disease, cancer, respiratory illness, and other diseases. Industrial farm animal production tends to be concentrated in low-income, rural communities, where residents may be more vulnerable to air pollutants due to pre-existing diseases, other exposures and stressors, and poor access to medical services. These communities lack the political clout to prevent citing of polluting facilities or to pressure industry and government to follow and enforce regulations. Policies intended to reduce reliance on fossil fuels have the potential to increase environmental injustices and threats to environmental health.