Although the exact incidence of child abuse is not known, it is estimated that over 1 million children are maltreated in the United States each year. Violence against children, whether from emotional abuse and neglect or from unintentional injury to the child from violence between adults, is basically a disease of adults that finds expression in children. The spectrum of child abuse covers physical or mental injury, nutritional or hygienic neglect, delayed or inadequate treatment of disease, sexual abuse, and verbal abuse. The diagnosis of child abuse can be facilitated by obtaining a history of the injury, clinically examining the child, and evaluating behavior changes. No pattern of injury or family background will conclusively prove an instance of child abuse. Close cooperation between community and medical resources involved in the care of a child provides the best opportunity for early detection and prevention of child abuse. Anatomic considerations in children's injuries are discussed, including size, skeleton, surface area, and psychological status. Specific injuries in child victims of violence are examined, such as cutaneous injuries, burns, head and chest trauma, abdominal trauma, and extremity trauma. 9 references and 1 photograph