Drowning is a frequent cause of accidental deaths and injuries, resulting in a significant but preventable global health problem. It is characterized by respiratory impairment due to submersion of the airway, or immersion of the body including the airway, leading to global hypoxic injury. Risk factors for drowning include inadequate supervision of children, recreational or occupational access to water, risk-taking behaviour and underlying medical conditions. Management priorities include rescue and basic life support, with an emphasis on rescue breaths and reversal of hypoxia. Compression-only cardiopulmonary resuscitation is not recommended in drowning victims. Supportive critical care is directed towards optimizing oxygenation and circulation, and preventing complications. Temperature control is important, as hypothermia complicates drowning and may limit the efficacy of resuscitative attempts when severe. Survival rates after cardiac arrest due to drowning are poor, and patients who are unconscious on admission to hospital have a guarded prognosis. Consequently public health initiatives to prevent drowning are important.