During the study period (2000-2008), there were 188 referrals to the Suspected Child Abuse and Neglect (SCAN) team in King Abdulaziz Medical City for the National Guard. Of these, 133 (70.7 percent) were investigated further as CAN cases. The number of referred cases increased from 6.4 cases per year in the first period (2000-2004) to 61.5 cases per year in the third period (2007-2008). The mean age of the children in these cases was 5 years old, evenly represented by boys and girls. Physical abuse was the most common form of abuse (61 percent) in the first period and the second period (2005-2006) at 76 percent. Neglect was the most common form of maltreatment (41.6 percent) in the third period. Parents were the perpetrators of CAN in 48.9 percent of the cases throughout the three periods. Fatality rates were 4.4 percent, 14.3 percent, and 7.9 percent in the three periods, respectively. This study concludes that the recognition of CAN is increasing in Saudi Arabia due to the successful adoption of a system of intervention that involves child protection centers in the medical facilities combined with mandatory reporting and data collection strategies. In addition, the changes in public attitudes toward a better understanding of CAN enhanced further recognition and reporting of neglect and milder forms of abuse. This study involved the collection of data on all children evaluated by the SCAN team in the three periods, in parallel with the stages of development of the national child protection system. 2 tables, 2 figures, and 21 references