Child death review involves a systematic, multidisciplinary, and multiagency process to coordinate data and resources from the coroner, police, the courts, child protective services, and healthcare providers. The Orange County team reviews all coroner's cases (unattended death or questionable cause of death) for children 12 years old and younger. Orange County child-abuse deaths were compared to all child deaths in the county by age, sex, and race. Child-abuse deaths were contrasted with other intentionally caused deaths and in turn compared to all other cases reviewed by the team. These were then compared to all other deaths that occurred in the county during the study period. This approach identified the characteristics of potentially suspicious child deaths compared to all child deaths. In addition to age, sex, and race, case characteristics encompassed cause of death and cause of death by age, gender, and ethnicity. The study concludes that the Orange County Child Death Review Team has proven more effective than a single agency in identifying the causes of child fatalities. This has been especially true for cases that have yielded confusing physical findings or plausible alternative explanations of death causes. The results have been more focused and more complete, and the process has been more accountable; interagency communications have been improved and integrated; and surviving siblings have been identified and referred for protection, evaluation, and service. 7 figures and 7 references