Post mortem examinations were carried out on 52 patients who died from major burn injury from 1971-1985. Causes of death were accounted for by pneumonia and sepsis 44.2%, shock syndrome 21.2%, and cardiac failure 19.2%. The relationship between duration of survival and cause of death revealed that if the patient died in the first three days after burn injury it was usually due to "shock", if between the fourth to twentieth day then 34.6% had pneumonia and 30.8% cardiac failure. "Accidental" sepsis (46.1%) was the most frequent cause of death after three weeks. Clinical and pathological diagnosis varies between burns centers and may cause confusion. An international standardization register should be sought to permit comparison of results.