Tetanus is a severe disease characterized by muscle spasms. It is completely preventable by immunization and adequate hygiene measures. Improved vaccination, particularly of pregnant women and infants, has resulted in a reduction of tetanus in women, children, and neonates. However, in 2005, 49 countries have still failed to eradicate maternal and neonatal tetanus and the disease continues to be a major global public health problem. Its treatment requires modern intensive care facilities, and even then mortality is high. This article describes the epidemiology, pathophysiology, and clinical features of tetanus as well as strategies for disease prevention. © 2008 Copyright © 2008 Elsevier Inc. All rights reserved.