Commercial fishing is one of the most dangerous jobs in the United States, with a work-related fatality rate 23 times higher than for all workers in 2016 1. Falling from a fishing vessel is a serious hazard responsible for the second highest number of fatalities in the industry after vessel sinking events 2, 3. The National Institute for Occupational Safety and Health (NIOSH) analyzed data on unintentional fatal falls overboard in the US commercial fishing industry to identify gaps in the use of prevention strategies. NIOSH researchers examined each fall overboard to determine the circumstances of the fall, including worker activity, primary cause, and contributing factors. Recovery attempts were also considered, noting any use of survival or rescue equipment and administration of medical treatment.