Reduction of pressure ulcers is a key government target, with particular emphasis on the more serious category 3 and 4 ulcers. An audit using photographs of pressure ulcers identified that nurses could correctly classify pressure ulcers 56% of the time using the European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel classification system. An intensive training programme resulted in an increase in accuracy of grading pressure ulcers to 62%. The results of this audit call into question the accuracy of pressure ulcer prevalence figures and highlight the difficulties experienced in classifying pressure ulcers.