Toxic shock syndrome (TSS) is a rare complication of colonisation or infection by toxin-producing strains of Staphylococcus aureus and has often been associated with tampon use, although menstrual-associated TSS has declined over recent years. Non-menstrual-associated TSS can occur in a variety of conditions including small percentage burns in children. Adults with burns are not normally at risk, but there have been a few reported cases. This article will discuss what factors are involved in the development of TSS in people with burn wounds.