The records of 324 children who were injured in road traffic accidents (RTA) between January 1992 and December 1995 were reviewed to determine the pattern, severity and outcome of their injuries. This represented 2% of all attendances at the emergency room. Pedestrians represented the largest group of patients. Head injuries were the most common injury, followed closely by limb trauma. Chest and abdominal trauma accounted for only 2.5 and 1.5% of patients, respectively. Eighty percent of abdominal injuries required a splenectomy, but most chest injuries were managed nonoperatively. In 306 children the ISS was 1-25 with no mortality but significant morbidity. Eighteen patients had an ISS of 26-54 with a 61% mortality rate (11 patients). The highest ISS were found in the group of patients who were passengers in a motor vehicle.