Results indicated that the presence of petechiae was significantly more common in injuries suspected of being non-accidental. The prevalence of petechiae in children with suspected non-accidental injury (190 children) was 16.3 percent compared with 1.5 percent in children with accidental injuries (263 children). When the sample of children was re-grouped into non-accidental injury (128 children), accidental injury (250 children), and inconclusive (75 children), the presence of petechiae was noted most frequently in the non-accidental group. In the non-accidental group, 28 cases had identified petechiae. Of these 28 cases, 23 contained petechiae on the head and neck and 24 had associated bruising. The findings suggest that the presence of petechiae increases sixfold the likelihood that the injury was non-accidental. The absence of petechiae, however, does not exclude non-accidental injury. Data were drawn from the case files of 190 children referred to a community pediatric clinic for suspected non-accidental injury between November 1998 and October 2000 and from the files of 263 children attending the Accident and Emergency Department with minor trauma over a 2-week period in January 2001. Data were also gathered from examining doctors who completed a “short research proforma” at the time of the examination. Data analysis included the calculation of likelihood ratios. Future research should focus on identifying the patterns and sites of bruising in accidental and non-accidental injury as well as patterns of bruising related to age. Tables, references