In this population-based descriptive study covering the 50-year period, 1945-94, there was a statistically significant increase in distal forearm fractures due to severe trauma in both women and men (p < 0.001) but no secular increase in fractures due to moderate trauma (approximately osteoporosis). Since fractures attributed to severe trauma comprised a greater proportion of the total in men (52%) than women (21%), an overall doubling of age-adjusted forearm fracture incidence in men between 1945 and 1994 was statistically significant (p < 0.001), but the 7% increase in age-adjusted rates among women was not (p = 0.90). While the epidemiological pattern of distal forearm fracture incidence in Rochester was similar to that seen elsewhere, the overall incidence rate of 287.4 per 100,000 person-years (95% CI 267.7-307.1) in 1985-94 was less than current rates in Sweden, presumably because the great increase in distal forearm fracture incidence seen, for example, in Malmö between 1953-57 and 1980-81 was not observed in Rochester. The trends in distal forearm fracture rates in Rochester men and women over the past 50 years are broadly consistent with trends in hip fracture incidence in this community over the same time span.