Two hundred and thirty-three children who had musculoskeletal injuries related to the use of off-road vehicles were admitted to acute-care hospitals in the two largest urban centers in Manitoba between April 1979 and August 1986. There were 190 boys and forty-three girls, and the ages ranged from two to seventeen years. Ninety-three accidents involved the use of a minibike or dirtbike; seventy-two, a snowmobile; fifty-nine, a three-wheeled all-terrain vehicle; and nine, a four-wheeled all-terrain vehicle. The injuries in 73 per cent of the children occurred in a rural setting. The use of alcohol or a drug was recorded for only three children. Loss of control of the vehicle led to the majority of injuries. There were 352 fractures of an extremity or the spine and fifty-one major soft-tissue injuries of the musculoskeletal system; 186 (53 per cent) of the fractures were displaced, 107 (46 per cent) of the patients had more than one fracture, and thirty-four (10 per cent) of the fractures were open. There were sixty growth-plate injuries. A total of 186 associated injuries were present in ninety-one patients. In a separate review of the records of the Chief Medical Examiner, it was noted that twenty-one fatal accidents that were related to the use of off-road vehicles occurred in the Province of Manitoba during the same period of time.