An in-depth analysis of U.S. residential fire statistics shows that although the total number of fires and deaths due to mattress fires has dropped as a result of several regulatory approaches, the number of deaths per 1000 mattress/bedding fires has increased over past 3 decades. To address the increasing number of deaths due to mattress fires, the open flame mattress flammability regulation (16 CFR 1633) was recently introduced in the U.S. The 16 CFR 1633 prescribes performance standards rather than design standards; this allows manufacturers the flexibility to meet the needs of the consumer without sacrificing fire safety. This flammability regulation for residential mattress has generated much interest in understanding the burning behavior of mattresses as well as in developing new materials for mattress construction. To comply with this regulation, it is essential to understand mattress construction, fire performance testing, factors affecting mattress flammability, and compliance solutions. This report reviews the impact of current mattress flammability standards, examines factors affecting mattress flammability, and reviews full-scale and bench-scale test methods that are being developed for mattresses. The soft materials used in the mattress set, including cushioning materials, fire blocking materials, and tickings, act both individually and collectively to affect the fire performance. The performance of fire barrier materials designed to protect the inner cushioning material from heat and flame is largely dependent on the choice of cushioning material and ticking. When used with an incompatible combination of filling material and ticking, a fire barrier may fail to protect thermal degradation and subsequent burning of filling material. Some of the challenges in designing mattresses have been identified and reported here.