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Introduction: The true incidence of carbon monoxide (CO) poisoning is not clearly known, but a description of possible trends could aid in prevention.Methods: Investigators searched Utah state databases for emergency department (ED) visits and admissions for CO poisoning and medical examiner records for CO-related fatalities.Results: From 1996-2013, 7,590 individuals were diagnosed with CO poisoning: 6,469 were treated/released from EDs; 596 were admitted; 525 died. Of 7,065 non-fatal poisonings, 5,950 (84%) were accidental and 498 (7%) were suicide attempts. Few patients (9.7%) were treated with hyperbaric oxygen. For accidental poisonings, internal combustion engines accounted for 43%, smoke inhalation, 34%, and heating sources, 22%. Internal combustion engines were implicated in 97% of suicide attempts. Non-fatal poisonings declined following a 2008 legislative change requiring CO alarms in residences, but we do not know if legislation caused the decline. One hundred forty-one (27%) fatal poisonings were accidental, 361 (70%) suicides and two (0.4%) homicides. Victims with cardiovascular autopsy findings/past cardiovascular history had lower carboxyhemoglobin levels (mean 51.2%, n=53) compared to those without (70.8%, n=472). Mean postmortem carboxyhemoglobin was highest in ages 20-29 years (72.5%).Conclusions: The incidence of CO poisoning in Utah is declining, but CO poisoning is still common. Alarm legislation may aid ..