An anonymous postal questionnaire was sent to 200 occupational physicians in the UK to determine their activities, the nature of the organizations within which they work and their attitudes and practices with respect to audit. One hundred and sixty-six physicians responded to the questionnaire, of whom 119 (72 per cent) were currently practising occupational medicine. Fifty-seven (48 per cent) of these 119 were engaged in some form of audit but only 21 (18 per cent) were engaged in an audit of structure, process and outcome. Assessment of continuing fitness for work or sickness absence ranked first overall with respect to the proportion of the physician's time engaged. The study revealed a wide diversity in the organization of the practice of occupational medicine, in the qualifications of occupational physicians and in their participation in audit. Needs for the development and wider implementation of methods of audit in occupational medicine have been identified by the study.