On June 7, 2007, the US Occupational Safety & Health Administration initiated a Petroleum Refinery Process Safety Management (PSM) National Emphasis Program (Refinery NEP) in response to a large number of fatal or catastrophic incidents in the petroleum refining industry. The program's intent is to inspect all refineries under federal jurisdiction within 2 years using a newly developed inspection protocol. This article briefly describes the inspection protocol, progress in completing the inspections, and review findings from this NEP and other PSM inspections conducted since 1992. Data on which paragraphs of the PSM standards were most frequently cited is included. Published 2009 American Institute of Chemical Engineers Process Saf Prog 29: 108-112, 2010*