Objectives: this study estimated the frequency of recent falls and prevalence of fear of falling among adults aged 65 and older.

Design: a cross-sectional, list-assisted random digit dialling telephone survey of US adults from 2001 to 2003.

Subjects: 1,709 adults aged 65 or older who spoke either English or Spanish.

Methods: prevalence estimates were calculated for recent falls, fall injuries, fear of falling and fall prevention beliefs and behaviours.

Results: an estimated 3.5 million, or 9.6%, of older adults reported falling at least once in the past 3 months. About 36.2% of all older adults said that they were moderately or very afraid of falling. Few older adults who fell in the past 3 months reported making any changes to prevent future falls.

Conclusions: the high prevalence of falls and fear of falling among US older adults is of concern. Both can result in adverse health outcomes including decreased quality of life, functional limitations, restricted activity and depression. Older adults’ fear of falling and their reluctance to adopt behaviours that could prevent future falls should be considered when designing fall prevention programmes.