The purpose of this study was to examine altered pressure garments requested by burn patients, in Taiwan. Three hundred forty-two pressure garments needing alterations were collected from 127 burn patients at the Sunshine Foundation Organization, an nonprofit organization for burn patients, between March and September 2007, to identify the major defects found in these pressure garments and their causes. Causes of required alterations were classified according to a hierarchical coding scheme focusing on poor fit, discomfort, component part, fabric and sewing, and cosmetics to identify systematic problems for each garment type. The result of our analysis indicated that the majority of the pressure garment alterations were related to poor fit in circumferential and longitudinal dimensions of the various body parts, incorrect position and size of openings for eyes, nose, ears, and mouth, or inappropriate length or position of zippers. Information derived from this causal analysis can be applied in helping to reduce the recurrence of alterations in pressure garment, thus improving the quality and effectiveness of pressure therapy.