Background Parents have the primary responsibility for safety of their under-fives due to the obvious inability of children to conduct appropriate risk appraisal, and to differentiate safe from unsafe situations. The complex and multi-causal nature of child injuries demands contextual investigation of these injuries. The paucity of evidence in Iran encouraged us to conduct this qualitative research.

Objective To explore parents’ practices for protecting young children against unintentional home injuries.

Methods Eighteen parents who had children younger than five years were recruited from three selected health centres in Tehran city. A quota sampling strategy focused on children’s age and the socioeconomic status of families was utilized. Two main sources of data were employed: semi-structured in-depth interviews with parents, and observation of their home environment. Inductive thematic analysis and content analysis were used for analysing interview transcripts and observational data, respectively.

Findings The interviews with parents and their home observation revealed that they prevented some domestic child injuries through both active and passive preventive measures including education, supervision, and keeping hazards out of the reach of children. However, despite parents’ efforts to protect their children against injuries, several hazards were found in all homes and in different rooms.

Additionally, families’ performance about childproofing their home against hazards were cross-checked with their comments. Parents had positive attitudes for adopting safety measures but their knowledge regarding injury risk factors for children was poor.

Conclusion Parents are more likely to adopt safety measures if they receive home safety education and are aware of injury outcomes. Further, supportive safety legislation and law enforcement as well as environmental modification are crucial for removing hazards related to home structure.

Policy implications The study findings are supported by the three E’s approach. They should be helpful to families, health professional, and policymakers in promoting children’s safety in their homes.