The number of reported cases of child abuse has increased dramatically over the past several years. Maltreatment of children can take several forms including neglect, sexual abuse, physical assault and psychological trauma. Five cases of child abuse presenting initially to the Otolaryngology Service are outlined: bilateral auricular hematomas, recurrent tympanic membrane lacerations, a pharyngeal laceration with retropharyngeal abscess and medical neglect of a patient with a parotid malignancy and one with laryngeal papillomatosis. Characteristic presentations and risk factors in family background are discussed toward the goal of early recognition and appropriate intervention.