Accidents caused by roof falls are commonly faced problems of underground coal mines. These accidents may have detrimental effects on workers in the form of injury, disability or fatality as well as mining company due to downtimes, interruptions in the mining operations, equipment breakdowns, etc. This study proposes a risk and decision analysis methodology for the assessment and management of risk associated with mine roof falls in underground coal mines. In the proposed methodology, risk assessment requires the determination of probabilities, possible consequences and cost of consequences. Then the risk is managed by the application of decision-making principles. The probabilities are determined by the analysis of 1141 roof fall data from 12 underground mines in the Appalachian region. The consequences are assessed based on the type of injuries observed after roof falls and the place of the mining activity. The cost of consequences is modeled by the so-called "relative cost criterion". A decision analysis framework is developed in order to manage the evaluated risk for a single mine. Then this model is extended to a regional model for the management of the roof fall risks in the mines of whole Appalachia. The proposed model is illustrated with an example and it is found to be a powerful technique for coping with uncertainties and the management of roof fall risks. (C) 2003 Elsevier Ltd. All rights reserved.