Patient falls are a serious problem, contributing to the morbidity and mortality of the elderly patient. This study reports on the development of the Morse Fall Scale. The scale consists of six scored items and discriminant analysis correctly classifies 80.5% of the patients. Validation of the scale by computer modeling was conducted. Data were randomly split and that analysis procedure repeated. Variables were obtained and weighted using half of these data, and these weights were tested on the remaining data. Similar results were obtained. Sensitivity of the scale was 78% and the positive predictive value, 10.3%. Conversely, specificity was 83% and the negative predictive value, 99.3%. Interrater reliability scores were r=.96. A prospective study in three clinical areas showed that the scale is sensitive to different patient conditions and to length of stay. Thus, the scale permits identification of the patient at risk of falling so that prevention strategies may be targeted to those individuals.