Dust explosions occurring in grain elevator storage and processing operations are increasing in frequency and are a world-wide source of injury and fatality. Despite extensive investigation by both private and governmental interests, the causes of most grain dust explosions remain a mystery. A number of methods to help prevent such explosions have been developed, but none has gained uniform acceptance. Despite a brief contact with flame in the flash of a dust cloud ignition, temperatures may exceed 1,000 degrees F and can cause severe burns. A single burn center's experience with eight patients injured in three separate grain elevator dust explosions during a 12-month period highlights the potential seriousness of the problem. Physicians practicing in grain producing or shipping areas of the world should be aware of the potential hazard imposed by grain storage operations. Prevention of these explosions by mandatory dust control systems and appropriate safety regulations is emphasized.