The Critical Oxygen Index test has been used as a measure of the flammability of a wide range of substances, including plastics, textiles and liquids, since its introduction in 1966. The index, however, is only appropriate to the configuration and conditions used in the test, and extrapolation in order to predict the flammability of materials in a large-scale fire is not valid. The index is dependent on a number of sample and test parameters and these are reviewed; the ASTM test standard, the reproducibility of the results, and certain theoretical aspects are also discussed.