The number of railroad events reported to the Agency for Toxic Substances and Disease Registry’s Hazardous Substances Emergency Events Surveillance system increased from 84 in 1993 to 177 in 1998. Comparisons of data on railroad and non-railroad events were made. The results overall indicated a greater potential impact of railroad events on public health. A median number of 2039 persons were living within a 1-mile radius of railroad events versus 982 for non-railroad events. The percentage of events during times when people are more likely to be home was also greater for railroad events. Railroad event victims were more likely to need hospital treatment than non-railroad event victims, which suggested the need for better community planning, reevaluation of current federal regulations and priorities for railroad hazardous material transport, and enhanced railroad industry commitment to safety.