More than 20,000 people under age 20 are killed or injured by firearms each year. Gun violence is the second leading cause of death to young people ages 10 to 19. It imposes significant economic and psychological costs upon society. Keeping children and youth safe from gun violence and restricting young people’s unsupervised access to guns need to be key priorities for legislators, law enforcement, public health practitioners, educators, and parents. Knowledge and research about how gun violence affects children and youth are presented here, along with policies that hold promise for reducing youth gun violence. An analysis of the physical, economic, and psychological effects of gun violence by and against children and youth is provided, as well as recommendations for reducing youth firearm deaths and injuries. There is an overview of trends in firearm-related injury and death among Americans under age 20, and an assessment of which youth are most at risk for firearm death. A discussion is presented of how several interrelated factors influenced trends in violent crime in the 1980's and 1990's. An examination is provided of how guns are manufactured, marketed, and sold in ways that make them attractive and accessible to youth. A review of research regarding the psychological effects of exposure to gun violence on children and youth is presented, as well as a discussion of strategies that adults can use to help children cope with gun violence. Understanding and estimating the costs of gun violence against young people, research findings surrounding behavioral approaches to gun violence prevention, and a history of efforts to add product safety features to guns are discussed. Case studies are provided of how eight cities policed gun crime through police-citizen partnerships to address youth violence, aggressive enforcement against youth suspected of criminal activity, alternatives to arrest to change youth behavior, or a combination of approaches. Articles that describe the beliefs of Americans and the opinions of advocacy groups on both sides of the debate about youth gun violence are included. Bibliography