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Environmental factors are important predictors of fires, but no study has examined the association between outdoor temperature and fire-related burn injuries. We sought to investigate the relationship between extremely cold outdoor temperatures and the risk of hospitalization for fire-related burns.We carried out a time-stratified case-crossover study of 2470 patients hospitalized for fire-related burn injuries during cold months between 1989 and 2014 in Quebec, Canada. The main exposure was the minimum outdoor temperature on the day of and the day before the burn. We computed odds ratios (OR) and 95% confidence intervals (CI) to evaluate the relationship between minimum temperature and fire-related burns, and assessed how associations varied across sex and age.Exposure to extreme cold temperature was associated with a significantly higher risk of hospitalization for fire-related burns. Compared with 0 °C, exposure to a minimum temperature of −30 °C was associated with an OR of 1.51 (95% CI 1.22–1.87) for hospitalization for fire-related burns. The associations were somewhat stronger for women, youth, and the elderly. Compared with 0 °C, a minimum temperature of −30 °C was associated with an OR for fire-related burn hospitalization of 1.65 for women (95% CI 1.13–2.40), 1.60 for age < 25 years (95% CI 1.02–2.52), and 1.73 for age ≥ 65 years (95% CI 1.08–2.77).Extremely cold outdoor temperature is a risk factor for fire-related burns. Measures to prevent fires should be implemented prior to the winter season, and enhanced during extreme cold.Risk of burns during cold temperature has not been studied.We examined the association of cold temperature with risk of fire-related burns.At −30 °C, the odds of burns was 1.5 times higher than at 0 °C.Associations were stronger for women, young people, and the elderly.Extremely cold temperature potentially increases the risk of fire-related burns.