BACKGROUND Falls are an important cause of disability and mortality among elderly subjects. OBJECTIVE To study the features and incidence of falls in institutionalized elderly subjects. METHODS Prospective recording of all falls, occurring in a period of eight months, to 453 subjects older than 60 years, living a home for the elderly. Evaluation of functional status of subjects suffering falls, using the Spanish Red Cross score. One hundred and two subjects living in the same place, but not suffering falls, were considered as controls. RESULTS One hundred and three subjects, aged 80 +/- 6 years (24% of the sample) suffered falls. Most falls were during the day and while walking. Seventy percent of subjects suffering falls did not have a history of previous falls. Nine percent of those falling, suffered a fracture. Compared to controls, falling subjects had a more deteriorated functional and mental status and consumed more benzodiazepines and neuroleptics. CONCLUSIONS There is an association between functional status and psychotropic medication consumption and the incidence of falls in institutionalized elderly subjects.