The use of methamphetamine (MA) as a recreational drug has increased exponentially in recent years, resulting in an emergence of clandestine laboratories. Consequently, the frequency with which burn centers across the country are admitting patients injured as a consequence of the volatile manufacturing process of MA is increasing. This study focused on comparing outcomes between burn patients injured secondary to MA laboratory explosions and patients sustaining burns from other mechanisms. All patients identified to have suffered burns secondary to MA laboratory explosions between 1998 and 2004 were included in this study. These patients were compared with those who did not experience such burns during this same time period. In total, 19 patients were identified as having been burned in MA laboratory explosions. These patients had a larger component of third-degree burns (24.8% vs 13.5%; P < .05) as well as TBSA burned (28.4% vs 20.7%; P < .05). In addition, patients using MA had an increased incidence of inhalation injury (31.2% vs 6.1%; P < .05). They also exhibited a significantly increased frequency of complications, such as nosocomial pneumonia, respiratory failure, and sepsis. Overall, the rate of mortality was significantly increased in patients using MA (26.3% vs 8.5%; P < .05); however, no significant difference was observed after adjustment for age, burn size, and inhalation injury. MA burn patients have larger burn size, incidence of inhalation injury, and increased morbidity when compared with non-MA burn patients. © 2006 The American Burn Association.