In 14 hips in 11 children under 3 years of age, proximal femoral epiphysiolysis occurred from varying degrees of trauma. The vulnerability of the blood supply of the upper femoral epiphysis, and its important weight-bearing function, demands early diagnosis, reduction, and adequate fixation. The nature of the injury, however, determines the eventual outcome. Early diagnosis and investigation of the underlying pathology is necessary to avoid such complications as varus deformity, avascular necrosis, heterotopic new bone formation, non-union, and premature closure of the growth plate.