Background Fall accidents are responsible for about a quarter of all injuries and hospital treatments in Austria. Children in the age group of 0-4-year-olds undergo hospital medical examinations even more frequently due to accidents resulting from falls.

Methods An analysis was conducted of fall accidents suffered by 0–4-year-olds in residences, who were treated at the Department for Paediatric and Youth Surgery, by using the injury data base.

Results 4,709 accidents were identified as ‘falls at home’. In this group of 0-4-year-olds a peak could be observed during the first year of life, during which 28% of the falls occurred.

In the case of injuries, 18% were categorized as being medically serious injuries.

Thirty-nine percent of the falls could be categorized as falls from height. The couch in the living room was the most common piece of furniture from which falls occurred.

Conclusion In Austria, safety standards and laws are central components of human protection, which is why technical prevention will no longer be the central starting point for accident prevention work. In many cases, the behaviour of a child who is subject to psychomotor developmental conditions and/or the behaviour of an adult/parent is the effective starting point for safety work.

Learning Outcomes Parents are of paramount importance in protecting the youngest children. They are aware of the living environment of their child and the child’s current developmental steps. A sensitisation to both of these aspects is of great importance to the child’s safety during the first years of life.