This study analyzed 237 fatal ground-level falls occurring in decedents aged 65 years or older reported to the Seattle-King County Medical Examiner's Office during the year 2007. Head injuries accounted for 109 (46%) of the deaths, and nonhead injuries accounted for 128 (54%) of the deaths. Falls occurred in similar locations in both groups. Compared with those of nonhead injuries, decedents of head injuries were younger (82 vs 87.5 years), were more often male (58% vs 45%), died sooner after their injury (9 days vs 23 days), and were more likely treated with anticoagulants, especially warfarin (48% vs 16%). Subdural hematoma was the most common specific traumatic lesion, occurring in 86% of the decedents of head injury; skull fractures occurred in 13%. Decedents of head injury who were treated with anticoagulants, on average, sustained less severe head injury than those who were not treated with anticoagulants.