Piranhas have a reputation of being man-eating fishes, notwithstanding the absence of well-documented records of piranha attacks on human beings. Three sites in Suriname where piranha attacks on bathers have taken place are discussed. In two isolated villages on the Wayombo River, most victims were children. In one village, 30 piranha attacks occurred in a period of 12 years, bites were mostly on the feet, and injuries were relatively harmless. In the second village, attacks occurred in a period of 7 years, and injuries were more serious, including the loss of digits and large and deep wounds in legs, arms and trunk. Two victims were attacked by several piranhas simultaneously. At the third site, a recreation park on the Suriname River, most attacks involved a single bite on the feet and victims were able to walk back to the beach without being attacked by other piranhas. Piranha attacks on humans did not result in deaths. The recovery of a toe phalange (Wayombo River) and a piece of flesh including a nail (Suriname River) from the stomach of two piranhas identified the fish responsible for the attacks as Serrasalmus rhombeus. Attacks on humans by S. rhombeus were associated with high age 0+ piranha densities in the dry season, high human prey densities, commotion in the water by humans, and spillage of food, fish offal or blood in the water.