In this study we have tried to determine physician success in the collection of injury data during the emergency department visit. Prospective data were collected from all children between the ages of 0 to 18 treated for an injury. Data were collected at the time of the visit and by chart review the next day. At an urban, university-affiliated, children's hospital, data were collected on 2,156 injured children. Fifty-one percent of the data forms were completed by the treating physician. Physician completion rate was lower on the weekends (46%) than on weekdays (52%, P = .02). The most common mechanisms of injury were falls (34%), motor-vehicle crashes or pedestrians struck (13%), and nonintentional struck by blunt object (12%). The most common mechanism of injury in all age groups was falls. Our results demonstrate that emergency physicians are not successful data collectors. However, when physician data collection is combined with next-day review of patient records, virtually 100% of patients are captured. Active emergency department data collection is important because in contrast to studies which use hospital discharge and mortality data, we found that overall falls account for more injuries presenting to the ED than transportation-related causes. An active surveillance system in emergency departments that does not require extra work on the part of the treating physician would be ideal and may give a more comprehensive description of the scope of the injury problem.