Background Unintentional childhood injury is a major cause of mortality and morbidity among children (upto 18 years) across the globe and contributes to over 875,000 deaths annually worldwide. Global Childhood Unintentional Injury Surveillance estimates that nearly 50% of children under 12 years suffered severe unintentional injuries leading to some form of disability. Unintentional childhood injury is an under-reported public health problem in India. This study was undertaken to estimate the incidence and assess economic impact and medical consequences of unintentional childhood injuries among children between 0–14 years.

Methods This is a non-concurrent cohort study, conducted in 13 clusters of a rural block in Vellore. Double stage cluster sampling method was used to screen 1600 children with injury. Information regarding the impact and consequences of injury was obtained.

Results Childhood injury related morbidity was 292.5/1000/year. Children between 10–14 years (4.6%) and boys (4.5%) had a higher rate of injury. Majority of injuries occurred at home (44.8%) and most commonly on the lower extremity (51.7%). Falls (43.1%) was the most common cause of injury followed by RTIs (27.6%). The direct medical and non medical cost of treatment ranged from $US0.14 to $US74. The wages lost by the primary caregiver ranged from $US1.4 to $US90 and absenteeism from work ranged from 1–60 days. Sick absenteeism ranged from 0–45 days with a mean of 5.17 days. 50% of children missed school after an injury. The days spent with temporary disability ranged from 1–60 days with a mean of 4.08 days and 7.73% had permanent disability.

Conclusion Unintentional childhood injuries is an emerging public health problem which leads to significant injury related sickness absenteeism and disability. Boys and older children are the most common victims of injury. Prospective trials on the economic impact and medical consequences will help to gain a clear understanding of DALY and loss of productivity.