Based on notifications to the Danish Committee on Adverse Drug Reactions and to the Central Death Register, 30 cases of fatal drug-induced anaphylactic shock were identified during the period 1968-1990. The most frequent causes were contrast media for X-ray examinations, antibiotics, and extracts of allergens. Nine cases occurred outside hospital; they were mainly caused by the use of allergen extracts of moulds for desensitization in general practice. Fatal drug-induced anaphylactic shock is rare, estimated in the present study at 0.3 cases per million inhabitants per year.