The objective of this study was to describe the nonfatal unintentional injuries among children aged <15 years treated in four emergency departments (EDs) in Nicaragua. The 2004 Injury Surveillance System included all cases of injuries that attended the four hospital EDs (n = 37,577). We analysed the records of 13,426 children aged <15 years who sustained nonfatal unintentional injuries. The leading causes of injuries were falls (50.5%), blunt force trauma (13.2%) and transport-related incidents (11.5%). Transport-related injuries primarily involved cyclists (42.3%) and motor-vehicle passengers (32.5%). Ten per cent of the injured children were hospitalised. This is the first study to present the epidemiology of nonfatal unintentional injuries among children treated in EDs in Nicaragua. Unintentional injuries are an important cause of morbidity, but the burden remains largely unaddressed. The implementation of the already well-established transportation-related prevention strategies should be a priority. Prevention of falls (falls being the leading cause of injury among children) demands further study.