This study utilizes a unique database that allows for the calculation of the correlation of injuries to child passengers involved in motor vehicle accidents with the restraint system and the accident characteristics. The database contains 4600 records of accidents involving children age 12 and under that occurred in 13 counties in western New York State during 1991 and 1992. Injured subjects and non-injured subjects were selected from data provided by the New York State Department of Motor Vehicles identifying reported accidents involving the target population in the time period and geographical area defined. The data sources included police accident reports, emergency medical team reports, hospital records and contact with the parents of children who were in child restraints. In child restraint cases, the type of child restraint in use is identified and misuse or equipment failure is noted. Injuries to child occupants are presented in Maximum Abbreviated Injury Scale (MAIS) and Injury Severity Score (ISS) formats, with each specific injury assigned Abbreviated Injury Scale (AIS90) and International Classification of Diseases (ICD9) identifiers. Data presented include descriptive statistics concerning accident configurations and occupant and injury characteristics; no statistical comparisons are made. Analyses indicate that the risk of injury in this study is 58% for unrestrained children, 30% for children restrained by adult systems and 16% for those in properly used child restraints. The most severe injures to children in properly used child restraints included five children (2%) who sustained MAIS=3 injuries. MAIS ≥ 3 injuries were reported to 25 unrestrained children (6.5%, including 7 fatalities) and 13 children in adult restraints (2%, including 2 fatalities).