Background A flame burn is an injury of body tissues, including respiratory tract damage, due to exposure to a flame or its dense smoke. Flame burns cause some of the most physically and psychologically devastating forms of trauma. Compared to scald burns, flame burn patients have a higher mortality rate and a higher frequency of multi-organ failure. The purpose of this research was to investigate the trends, complications, and mortality risk factors of flame burns at the Department of Plastic and Burn Surgery (DPBS) of the People's Hospital of China Three Gorges University (PHCTGU). Methods A retrospective analysis of 48 flame burn patients — accounting for 8.3％ of the 576 burn victims admitted for burns at the PHCTGU from February 1, 2010, to September 30, 2019 — was performed after collecting information from the Burns Registry of the said hospital. Results The proportion of patients with flame burns was 8.3％ (n=48). The mean total body surface area (TBSA) affected was 27.6％. The mean duration of hospitalization was 32.5 days. The etiologies of the flame burns were as follows: gas explosions (21, 43.8％), ethanol (8, 16.7％), charcoal fire (7, 14.6％), petrol explosions (4, 8.3％), wooden houses (4, 8.3％), and others, including dust, cigarette lighter, and burning incense, accounting for 8.3％ of cases (4). Finally, 42 (87.5％) patients were treated and discharged, and 6 (12.5％) patients died. Complications included scarring in 38 (90.5％) patients, severe scar contractures on different parts of the body in 25 (60.0％) patients, scar ulcer in 6 (14.3％) patients, keloids in 3 (7.1％) patients, and scar cancer in 1 (2.4％) patient. Multiple complications occurred in the same patient. The only risk factor for mortality that was identified was TBSA (P=0.043). Conclusions Our study revealed that a small population (8.3％) was injured by flame burns, but 6 deaths were recorded. Society must continually enhance safeguard procedures to flames and strengthen education to protect life and avoid severe complications.