We reviewed 156 cases of spinal injury sustained by children aged 14 years and younger. Analysis included the following: categorizing injury as an orthopedic (112), a neurologic (2), or a combined (42) problem; site along spinal column at which injury occurred; cause of injury (most commonly automobile accident and fall); referral pattern and hospital stay; immediate and rehabilitative therapy; complications; and deaths. The frequency of spinal injury in children increases with age. The mode of injury in urban and rural environments varies. Spinal injury is a serious problem and has an associated high mortality and a high complication rate. Most of the spinal injuries are preventable, and the incidence of complications can be lessened when special attention is given during the initial hospitalization to respiratory and urinary tract infections, decubiti, and behavior of the children.