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Balance is an important component of daily function and impairments can lead to injury and quality-of-life limitations. Balance is not well studied in the burn population. This study examines the frequency of long-term balance impairments and associated factors after a burn injury. The Burn Model System National Database was analyzed. Trouble with balance was self-reported at discharge, 6, 12, 24, and 60 months after injury. Regression analyses examined the associations between demographic and clinical characteristics and balance impairments at 12 months. Of 572 participants, balance impairments were most reported at discharge (40.3%), continuing over 60 months (26.8-36.0%). Those reporting balance impairments ( n = 153) were more likely to be older, unemployed, have Medicaid or Medicare, receive inpatient rehabilitation, receive outpatient physical or occupational therapy, have vision problems, have leg or feet burns and swelling, and have foot numbness compared to those without ( p ≤ 0.001). Regression analysis demonstrated a 4% increased odds of balance impairment for every increase in year of age ( p < 0.001), 71% lower odds if employed at time of injury ( p < 0.001), and 140% higher odds if receiving outpatient physical or occupational therapy at 12 months ( p = 0.008). Common reports of balance impairments highlight the need for routine screenings to identify burn survivors that may benefit from targeted interventions., Competing Interests: Ryan received financial support from MediWound for contracted research. This funding did not directly or indirectly impact this work. The remaining authors have no relevant financial or nonfinancial interests to disclose.