Geospatial analysis of the incident address of 1399 opioid-related overdose deaths, by census tract (n = 395), Allegheny County, Pennsylvania, 2008-2014. Hot spots are spatial clusters with significantly higher counts of fatal overdoses compared with counts in the rest of the county, and cold spots are spatial clusters with significantly lower counts of fatal overdoses. The hot spots with the greatest number of opioid-related deaths compared with other municipalities and Pittsburgh neighborhoods were Brookline, Baldwin Township, Carrick, and Overbrook (indicated by solid grays and black toward southwest). The cold spots with the least number of opioid-related deaths were the Pittsburgh neighborhood of Point Breeze and municipality of Wilkinsburg (indicated by patterns toward northeast).