Background The lack of data on prevalence, risk factors, costs and consequences of child injuries has led to a lack of awareness and understanding of the problem in low income countries.

Aim To investigate whether socio-economic status of families is associated with injury morbidity among children in rural Nepal.

Results A community based household survey was conducted in Makwanpur district, Nepal. Families of children with injuries, which required treatment or caused problems for at least 3 days, were interviewed. A total of 2868 households were analysed using Factor Analysis to create SES wealth status and the households were ranked into five quintiles. The relationship of wealth status with socio-economic and demographic characteristics will be presented.

Findings Only 6.3% (181) of survey households reported that a child was injured. Injured children disproportionately came from the lowest wealth quintiles. The ratio of lowest to highest quintiles was 1.37 (PCA). OR for the lowest SES quintile (1.27; 95% CI 0.78 to 2.06) when compared to the highest. OR for having 3–4 children per household (2.30; 95% CI 1.62 to 3.27) and for having 5 or more children per household (3.42; 95% CI 2.45 to 5.21) compared to 1–2 children per household; the second lowest and middle quintiles have highest injury risk. Having three or more children/household was found to be a risk factor for child injury. The ORs exhibit complex trends with increased SES levels.

Significance There are few examples of studies examining child injury and inequalities in low and middle income countries. There is a need to study inequalities in injury to help guide more effective prevention.