Falling coconuts can cause injury to the head, back, and shoulders. A 4-year review of trauma admissions to the Provincial Hospital, Alotau, Milne Bay Province, Papua New Guinea, revealed that 2.5% of such admissions were due to being struck by falling coconuts. Since mature coconut palms may have a height of 24 up to 35 meters and an unhusked coconut may weigh 1 to 4 kg, blows to the head of a force exceeding 1 metric ton are possible. Four patients with head injuries due to falling coconuts are described. Two required craniotomy. Two others died instantly in the village after being struck by dropping nuts.