Data from Federal publications show an alarming increase in firearm deaths in recent years. Compared to 1985, the data for 1988 show that for all circumstances, the number of deaths increased from 3,089 for 1-19 year-olds in 1985 to 3,873 in 1988, a 25-percent increase. The greatest increases were in the number of homicides, which increased 22 percent for 5-9 year-olds, 29 percent for 10-14 year-olds, and 54 percent for 15-19 year-olds. Rates also increased most for homicide, up 33 percent for 5-9 year-olds, 38 percent for 10-14 year-olds, and 65 percent for 15- 19 year-olds. Age and gender are the strongest demographic risk factors for firearm fatality, with the incidence being greatest for teens and young adults who are males. A recent study of adolescent suicide victims shows that suicide was more likely when firearms were present in the home. Most firearm injuries are caused by handguns, although more long guns are owned. Because of the high lethality of firearm injuries, primary prevention is the only logical approach. The American Academy of Pediatrics emphasizes restrictive legislation, because there is evidence that legal restraint on handgun access lowers both homicide and suicide rates. Also, experience with other types of injury control has taught that education alone does not suffice to optimize prevention strategies. Further, the longevity and lethal purpose of handguns will limit the potential for weapon design improvement to have a substantial impact on injury rates in the short term. Finally, the interests of children demand that the most effective approach be taken as quickly as possible. 1 table