Injuries are a leading cause of death and disability in children. This report presents evidence on how they can be prevented and calls for greater commitment and action from policy-makers and practitioners to decrease the burden. Every year, unintentional injuries kill nearly 42 000 children and young people under the age of 20 in the WHO European Region. Injuries are the leading cause of death among those aged 5-19 years, and 5 out of 6 of these deaths occur in low- and middle-income countries. Irrespective of country income, the burden falls disproportionately on children from the most disadvantaged groups. The leading types of unintentional injuries are road traffic injuries, drowning, poisoning, burns and falls. All injury types have similar main causes and socioeconomic and environmental determinants. Children are particularly vulnerable to injuries and need special consideration to safeguard their rights to health and safe environments, free from injury. This report, companion to the World report on child injury prevention, presents the evidence on both the great potential for injury prevention and the effectiveness and value for money of measures already in use in European countries with low injury mortality. It shows why health systems and particularly programmes for child health throughout the WHO European Region should give priority to preventing and controlling child injury.