Over a 12-month period 430 children under 14 years of age presented to Red Cross War Memorial Children's Hospital in Cape Town having been injured as pedestrians, and 106 children who died from such injuries were registered at the regional state mortuary. Information about the circumstances surrounding injury was obtained from the parents or guardians of all children reporting to hospital and 48 (45.3%) of the fatalities. Analysis of results revealed a strong relationship between pedestrian injury and children playing or running errands in residential areas during daylight hours, particularly in the later part of the afternoon. Only 24.3% of all children were supervised by an adult at the time of injury. The pattern of behaviour described must be acknowledged in the planning of future road safety measures. The inconsistency of parental supervision highlights the need to include adults in educational and awareness campaigns.