The purpose of this paper was to examine caregiver supervision and its role as an active strategy in childhood injury prevention. Through a review of the literature, the authors addressed conceptual and methodological issues related to supervision, such as the question of how to define 'adequate supervision.' Three critical dimensions (attention, proximity and continuity) of caregiver supervisory behaviors are identified as important areas for measurement. Presented is a framework for understanding the role of passive and active supervisory behaviors within the social context. The framework includes family and community characteristics and policies/regulations that may be important in caregiver decisions to use active or passive injury prevention strategies. Future research directions are discussed.