Many thousands of individuals are submersion victims each year in the United States. The majority of victims are young, previously healthy people. There have been no recent breakthroughs in medical technology or treatment modalities that have improved survival rates for submersion victims. The key to their successful outcome and return to productive, full lives is aggressive resuscitation by emergency physicians and prehospital care providers. Most submersion incidents should never take place. Emergency physicians can take the lead in public education and prevention.