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Objectives: We investigated an outbreak of carbon monoxide (CO) poisoning after a power outage to determine its extent, identify risk factors, and develop prevention measures., Methods: We reviewed medical records and medical examiner reports of patients with CO poisoning or related symptoms during December 15 to 24, 2006. We grouped patients into households exposed concurrently to a single source of CO., Results: Among 259 patients with CO poisoning, 204 cases were laboratory confirmed, 37 were probable, 10 were suspected, and 8 were fatal. Of 86 households studied, 58% (n = 50) were immigrant households from Africa (n = 21), Asia (n = 15), Latin America (n = 10), and the Middle East (n = 4); 34% (n = 29) were US-born households. One percent of households was European (n = 1), and the origin for 7% (n = 6) was unknown. Charcoal was the most common fuel source used among immigrant households (82%), whereas liquid fuel was predominant among US-born households (34%)., Conclusions: Educational campaigns to prevent CO poisoning should consider immigrants' cultural practices and languages and specifically warn against burning charcoal indoors and incorrect ventilation of gasoline- or propane-powered electric generators.