Many writers have commented on the frequency with which old people express fear of falls but this fear has not been quantified. As part of an epidemiological study of falls in the elderly living at home, 203 people over 75 years of age were questioned about falls experienced in the previous 12 months, fear of falling and symptoms of dizziness, and assessments were made of their mood, cognitive function, physical state, dependence and mobility. Fear of falling affected the same proportion of subjects as falls themselves (42.4%) and although there was an association between fear of falling and having experienced falls, a third of non-fallers limited their activity because they were frightened of falling. Falls, fear of falling and subjective dizziness were strongly associated with anxiety and depression. Subdivision of fallers into outside and inside fallers or those who had fallen because of trips and ‘non-trip’ fallers produced groups which differed in their physical frailty, mobility and dependence, but even the otherwise healthy and independent outside fallers and ‘trip’ fallers had high anxiety and depression scores. This may be an indication of the psychological impact of falls.