ObjectiveTo determine the success of resuscitations performed by Queensland surf lifesavers and the factors associated with successful resuscitation.DesignRetrospective case survey, using data from Surf Life Saving Association of Australia resuscitation report forms.Setting54 Queensland beaches patrolled by surf lifesavers, and nearby areas, between 1973 and 1992.Outcome measuresReasons and success rates for resuscitation, distance from surf clubhouse, whether inside patrolled area, victim's age, sex, facial colour on presentation, occurrence of vomiting, airway difficulties and involvement of alcohol.Results171 resuscitations were reported (80% involving males and 20% females), with a success rate of 67%. Seventy‐two per cent were performed during patrol hours, 17% within patrolled areas (95% successful) and 55% outside patrolled areas (only 62% successful) (P = 0.004 for difference in success rates); resuscitation success rates fell with increasing distance from the surf clubhouse (P = 0.009). Reasons for resuscitation were: immersion, 70% (success rate, 68%); collapse, 22% (success rate, 47%); and surf or beach injury, 7% and 1%, respectively (success rate, 100% for each). Resuscitation was more likely to be successful if the victim's facial colour on presentation was normal, pale or blue, but not if grey, and if the victim did not vomit or regurgitate.ConclusionsResuscitation by surf lifesavers was highly successful when the victim was close to the surf patrol, indicating a need for funding to expand patrol areas. Public awareness of the greater safety of “bathing between the flags” (in the delineated patrol area) should be increased.