Iron burns to the hand may result in both functional and cosmetic deformities in the young pediatric patient. To gain a better understanding of these injuries in terms of demographics, treatment, and outcome, and to address possible measures for prevention, the medical records of 82 pediatric patients suffering iron burns to the hand during the period 1987 to 1993 were reviewed. Iron burns to the hand occurred most commonly in male children less than 2 years of age. Most were minor partial-thickness burns that were treated in the outpatient setting with no adverse sequelae. Fifteen percent of patients, however, sustained full-thickness burns that required grafting. Ten percent of patients developed complications including hypertrophic scarring and scar contractures requiring surgical release. Socioeconomic factors and parental inexperience appeared to play a significant role, as most of these injuries occurred in low-income, single-parent, single-child households. Most injuries were unintentional, however, many were caused by carelessness or neglect. Abuse was suspected or proven in 7% of cases. Parents may be unaware of the consequences of leaving a child unattended in the presence of a hot iron. The incidence of these injuries could be reduced effectively by improved public awareness of the problem and education in prevention.