Firefighters are called on to rescue people and protect property under serious and hazardous conditions. Some 100 firefighters die each year on duty, and another 95,000 are injured. Recommendations developed through the National Institute for Occupational Safety and Health (NIOSH) Fire Fighter Fatality Investigation and Prevention Program (FFFIPP) point to many safety practices that could improve the health and safety of the nation’s firefighters. The purpose of this report is to summarize the findings of a recent evaluation of the FFFIPP. Based on a national survey of fire departments and focus groups with frontline firefighters, the evaluation focused on firefighters’ awareness of FFFIPP recommendations, the extent to which recommendations are being implemented, the factors affecting implementation, and NIOSH’s dissemination practices. We learned that most fire departments are aware of the FFFIPP and follow its recommendations; nevertheless, various shortfalls, especially regarding cardiovascular health, motor vehicle safety, and procedures on the fireground, persist. The greatest shortfalls exist in small and volunteer fire departments where resources limit the ability to purchase needed equipment and prepare firefighters to carry out their duties safely. We identified numerous specific improvements that NIOSH could make to promote health and safety.