During 1950-1993, the overall annual death rate for U.S. children aged < 15 years declined substantially, primarily reflecting decreases in deaths associated with unintentional injuries, pneumonia, influenza, cancer, and congenital anomalies. However, during the same period, childhood homicide rates tripled, and suicide rates quadrupled. In 1994, among children aged 1-4 years, homicide was the fourth leading cause of death; among children aged 5-14 years, homicide was the third leading cause of death, and suicide was the sixth. To compare patterns and the impact of violent deaths among children in the United States and other industrialized countries, CDC analyzed data on childhood homicide, suicide, and firearm-related death in the United States and 25 other industrialized countries for the most recent year for which data were available in each country. This report presents the findings of this analysis, which indicate that the United States has the highest rates of childhood homicide, suicide, and firearm-related death among industrialized countries.