Results indicate that only three of the examined factors were significantly associated with a further abuse evaluation for young children with minor head injury: a positive head computed tomography (CT), a head injury of unknown mechanism, and a documented delay in seeking care. Other factors such as age of the patient and whether the event was witnessed or not were significantly associated with these outcomes. Findings suggest that physicians frequently did not record and might not use important information readily available to them in determining the need for an abuse investigation. Despite there being a known association with abuse, the patient's age, and developmental capabilities were not statistically associated with the initiation of further abuse evaluation. Information regarding the witnessing and timing of the injurious event and the onset of symptoms was poorly recorded. This study speaks to the need for greater physician education in child development, particularly as it applies to injury mechanisms. It also supports the use of protocols or clinical flowcharts for evaluating injured children. Lastly, clinicians working in acute care settings may benefit from regular continuing medical education on child development and abusive injury. Data were collected and subjects identified through the search of hospital databases using codes for conditions associated with head trauma and children less than 3 years of age from the years 2001 through 2005. Tables, references