Climatic conditions may affect the incidence of fractures and fall deaths. Analysis of national fatality data shows that among white women, those living in colder climates have higher rates of fall deaths. Fall deaths increase in winter in all regions, but especially so in colder states. In a prospective cohort study of 96,506 predominantly white female nurses 35-59 years of age, we found that, after controlling for personal and lifestyle characteristics, those women residing in colder climate also had a higher incidence of hip and forearm fracture. In colder states, fracture rates were substantially higher in winter than in summer. A cold climate appears to be a significant risk factor for both fractures and fall deaths among white women, particularly as they age.