The medical examiner determines cause of death and, in conjunction with law enforcement, circumstances. In addition, child protective services are involved in assuring the safety of children and can assist in understanding factors that contribute to death in child abuse and neglect cases. Despite the high stakes involved, many jurisdictions lack specific guidelines and procedures for conducting comprehensive child fatality investigations. The absence of standard guidelines and procedures may result in incomplete investigations and inhibit interagency cooperation. Poor interagency cooperation may have ramifications beyond the investigation itself; for example, lack of cooperation may hinder the criminal prosecution of a person responsible for the death of a child. Although guidelines and procedures vary according to jurisdiction, effective ones have certain shared characteristics: are clear and comprehensive to both seasoned and novice investigators, use simple rather than compound questions, cover all likely and unlikely situations that an investigator may encounter, are flexible enough to cover varied death circumstances, and substantively address an agency's mandate. Good interagency protocols for child fatality investigations identify objectives, agency mandates, death types, and individual and joint agency responsibilities and incorporate procedures for individual agencies involved in child fatality investigations and for investigating the circumstances of other children. Appendixes, constituting the bulk of the report, present guidelines and procedures to assist medical examiners, law enforcement personnel, and child protective services in child fatality investigations. Tables and figures