Falls are the 18th major cause of death in Australia. The intention of this study was to provide a comprehensive understanding of fatal falls in an Australian context through documenting the circumstances of fall-related deaths and investigating the characteristics surrounding those falls. A retrospective review of fatal falls in the state of Victoria from 2005 to 2014 was undertaken using the National Coronial Information System online database. Details recorded for each fatal fall case comprised the circumstances of the fall (year and month of fall, fall type, and manner and cause of death) and characteristics of the deceased (sex, age, body mass index, pre-existing conditions and psychoactive drug use). There were 2743 fatal falls, encompassing falls from a bed, chair, height (>3 m), horse, ladder, low height (≤3 m), motor vehicle, stair(s), standing, toilet, wheelchair and unspecified. The majority of falls were accidental (95.5%), indirectly contributed to the fatality (66.4%), were female (53.2%), elderly (61+years) (92.3%) and of a healthy weight (33.3%). Many had pre-existing conditions (86.8%) and several (19%) had psychoactive drug use. Findings are anticipated to contribute to prevention policy improvements and assist medico-legal death investigations.