The study investigated if incidences of death by drowning in the UK could have been prevented through the use of lifejackets over a ten year period. This study was a retrospective analysis of fatal maritime incident data collected by the Maritime and Coastguard Agency (MCA) between the years 2007 and 2016. A Casualty Review Panel (CRP) met annually to categorise incidents into five groups based on the likelihood of a lifejacket preventing death. Descriptive analyses were performed on the overall fatalities, data were stratified by year, sex, age, and activity. Ten year data were categorised based on the outcome of the CRP, these data were further stratified by year and activity, with trends being reported. Potentially 180 lives (82% of all cases successfully categorised) could have been saved if a lifejacket had been worn. An 18% reduction in the number of cases referred to the CRP was observed from the first 5 years (2007–2011 = 59% of all referrals) to the last 5 years (2007–2011 = 41% of all referrals), with 42% less cases referred in 2016 compared to 2007. The data generated by the CRP over the ten years has provided a unique insight into coastal deaths, it has provided a clear rationale for the use of lifejackets and has helped target national and activity-specific campaigns for water safety and lifejacket use.