We analyzed the causes and diagnoses, the treatment, short and long-term outcome of a consecutive series of 70 pediatric polytrauma patients. From 1989 to 1996, 70 children (aged 10 months to 16 years, mean 7.4 years) presented with multiple trauma. A follow-up investigation was performed 4.2 years (mean) after the accident. Traffic accidents (68%) were the leading cause of injuries. Among all injuries (mean ISS 24.6 range 17-57), injuries of the head/neck area were most frequent (87%) followed by extremity fractures (76%) and 135 operations were performed on 55 children, mostly for fracture stabilisation. All multiple injured children survived. At discharge 25 children were still impaired (36% of 70). At follow-up 58 patients were revisited, 11 (19% of 58) presented with impairments, 8 of those (73% of 11) following severe head trauma. This study showed a 10% rate of late impairment due to the severity of the primary head trauma.