Objectives. To estimate the burden of respiratory ill health in South African children and adults in 2000 from exposure to indoor air pollution associated with household use of solid fuels. Design. World Health Organization comparative risk assessment (CRA) methodology was followed. The South African Census 2001 was used to derive the proportion of households using solid fuels for cooking and heating by population group. Exposure estimates were adjusted by a ventilation factor taking into account the general level of ventilation in the households. Population-attributable fractions were calculated and applied to revised burden of disease estimates for each population group. Monte Carlo simulation-modelling techniques were used for uncertainty analysis.