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Aim To review the changes in management of inhalational injury and the associated reduction in mortality over the last 2 decades.Methods The records of bums patients with inhalation injury hospitalized in our institute from 1986 to 2005 were retrospective analyzed.Theincidence of inhalation injury and associated mortality,the relationship with age and total burn area,and the incidence of mechanical ventilation and tracheostomy were studied.Results The incidence of inhalation injury was 8.01% in the total 10608 hospitalized bum patients during the 20 years surveyed.Inhalation injury was always associated with large sized burn and more common in adults.