A review of the general characteristics of burn injury notes that infants are most likely to be abused with burns, that abusive burns are most frequent in the winter months and among lower economic classes, and that abusive burns are likely to be underdiagnosed. The discussion of specific patterns of abusive hot-water burns advises that tap-water burns are the most frequent and that forced immersion in hot tap water can usually be detected from the burn pattern. A review of specific patterns of other burns focuses on contact burns, the second most frequent cause of abusive burns, which usually involve contact with hot metal objects. Some general guidelines for physicians dealing with abusive burns are to take color photographs and ensure that each medical professional interacting with the family record as accurately as possible the history of the model and circumstances of the injury. Skeletal X-rays should be obtained where appropriate. Other signs of physical abuse and neglect should also be noted. The discussion concludes with a consideration of pseudoabusive and other nonaccidental, nonabusive burns. 35 references.