To the best of our knowledge, there has not been any recent available study of trauma-related hospitalisation of paediatric patients in an urban area of the sub-Saharan countries. Accidental injury, especially among children, has become one of the most serious major health problems facing developing countries, including those in sub-Saharan Africa. We reviewed 677 children admitted to the Komfo Anokye Teaching Hospital in Kumasi, Ghana, from August 1995 to July 1996 to elicit the incidence of various injuries, causes, rates of injury, and survival of children aged 0 to 14 years who had sustained trauma during this period. The most common mechanisms of injury were pedestrian knockdowns (40.0%), falls (27. 2%), and burns (17.6%). The annual rate of injury was 230/100000 children. Boys sustained higher injury rates in all age groups than girls, with an overall rate of, 136/100000 children as compared to 92/100000 for girls. Rates of injury were higher for children over 5 years of age in six of the seven specific causes of injury studied. When analysing the region of principal injury, for severe injuries (abbreviated injury scale 3-5) the extremities suffered most, followed by the skin and head. There was increased mortality for patients with an injury severity score >20. The overall mortality for this study was 5.5%. There is, therefore, a need to establish prevention priorities and to design effective prevention strategies for children of school-going age, who are most at risk of sustaining trauma.