An analysis of the role of attribution in major illness and serious injury is presented. Evidence reviewed includes the impact of illness variables on attributions, the association between attributions and adjustment to illness, and the proposed mechanisms of this association. Illness and injury characteristics such as severity and time since diagnosis appear to relate to attributional activity and content, but the association between attributions and psychological or physical adjustment is weak. Overall, it would appear that the attribution construct can describe individuals' reactions to life‐threatening illness or injury. However, the utility of attribution in understanding the processes involved in adjustment to illness has not yet been demonstrated.