In the current study, design and success of intervention programmes to prevent sudden infant death syndrome (SIDS) in Austria are described and major future challenges indicated. Various prevention programmes are being carried out in the federal states of Austria and they focus on the detailed information of parents about modifiable SIDS risk factors. Relevant topics such as guidelines for home monitoring are carefully addressed in the Austrian consensus statements. With the introduction of the first campaigns SIDS incidence rates have gradually dropped from 1.69 (1988) to 0.51 per 1000 life births (2000). In line, there was a decline in the prevalence of risk behaviour, especially of the prone sleeping position (federal state of the Tyrol: 53.7% before the campaign (1984-1994) vs. 4.7% thereafter (1995-2001), p < 0.001). Because of this latter trend smoking during pregnancy became the most prevalent SIDS risk factor and the prevalence of the side sleeping position substantially increased. To maintain the current success in lowering SIDS frequency, prevention programmes ought to continue and changes in the weight of risk factors should be considered. Further efforts are required to achieve a thorough post-mortem examination in virtually all sudden unexpected deaths, to establish a country-wide SIDS data base and to continuously update SIDS risk profiles in Austria.