Forestry management practices can shape patterns of health, illness, and disease. A primary goal for owners of federal, state, and private forests is to craft ecosystem management plans that simultaneously optimize forest health and human health. Fire­­a major forest management issue in the United States­­complicates these goals. Wildfires are natural phenomena with unpredictable effects. Controlled fires, on the other hand, are often prescribed to reduce biomass fuels, reduce wildfire risks, and protect resource values. While fires can enhance the health of fire-adapted ecosystems, research on the human health impacts of smoke from forest fires is somewhat equivocal. This article synthesizes 30 years of research on the human health impacts of forest fires. It summarizes our current state of knowledge about the following: biophysical effects of environmental contamination resulting from forest fires; psychosocial impacts of forest fires; occupational exposure issues among fire crew; visibility impairment from forest fire smoke; and health care measures that address the impacts of forest fires. This article provides information that may be useful for land managers, researchers, policy makers, health care workers, and the general public in decision-making about forest management practices. It also recommends that future research use integrative health models and adopt ethnographic research methods.