OBJECTIVE Transmission oximetry sites for intraoperative monitoring are frequently difficult to find in burn patients, as standard transmission oximetry sites are often burned or contained within the operative field. The objective of this study was to determine if reflectance oximetry is of potential value in monitoring this group of patients. METHODS A total of 16 operative procedures in a group of acutely burned adult and pediatric patients with an average age of 9.7 years (range, 10 months to 37 years), average burn size of 42% of the body surface (range, 15% to 94%), and average weight of 34.2 kg (range, 9 to 100 kg) were done with simultaneous transmission and reflectance oximetry monitoring. RESULTS During these 16 procedures in a diverse group of acutely burned adult and pediatric patients, there was no significant difference in saturations derived from transmission and reflectance oximetry probes. In smaller children, adequate signal for reflectance probe monitoring was often detected in hyperemic sites, such as healed partial thickness burn. CONCLUSIONS This is the first published report documenting both the clinical use of the reflectance oximetry in burn patients and the clinical use of the Nellcor Oxisensor II RS-10 reflectance oximetry probe (Nellcor Corporation, Hayward, CA). This technique can facilitate the intraoperative monitoring of acutely burned adult and pediatric patients in whom standard transmission oximetry sites are difficult to find.