Thermal injury frequently occurs in traumatized patients in North America and causes serious morbidity and mortality, predominantly to children and young adults. Over the past decade, considerable technologic advances have improved survival after burn injury. Ongoing research coupled with current surgical advances in equipment, technique, early wound closure and alternative forms of wound coverage offer the potential for greater survival with enhanced quality of life for traumatized patients with burn injuries. However, sepsis and inhalation injury remain important ongoing causes of death, for which the understanding and solutions appear to be unfolding as research into the multisystem effects of the inflammatory process continues.