For over 2 decades, every year approximately 100 firefighters have died in the line of duty. The fire service has been hard at work to develop programs to increase firefighter occupational safety. Even with solid safety initiatives in place, the fire service has not been able to make the desired substantial gains in decreasing firefighter injury and death rates. This study used the Delphi Method to explore barriers to firefighter safety in the American fire service. Through the use of a panel of experts a consensus was reached to answer the question of what are the perceived barriers to firefighter safety. This study concludes that a combination of factors such as firefighter culture, leadership, risk taking behavior and a sense of duty combine to cause proven safety behavior to be dismissed by firefighters leading to injuries and death. The goal of this study is to help to fill the gap in knowledge of why the fire service injury rate is virtually stagnant so that solutions may be developed to allow communities to save lives, have a higher degree of emergency readiness, and to save money.