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Animal abuse by children is common, with 3–44% of children being reported to abuse animals at some point during their childhood. Much of this behaviour may be regarded as an extension of exploratory behaviour in a younger child; however, the apparent link between child and animal abuse is an area of increasing interest; with children who abuse animals being 2–3 times more likely to be directly abused themselves. How concerned should a health professional be that a child who abuses animals could themselves be the victim of abuse? We reviewed the literature on the subject, finding that abuse to an animal that is perpetrated by an older child (>10 years) is more likely to be associated with child abuse. Animal abuse is less common in girls compared with boys and there is some suggestion that child abuse may be more likely in these cases. Some papers have reported a higher prevalence of animal abuse in children with attention deficit hyperactivity disorder, developmental delay and conduct disorder, but the relationship with child abuse in these cases is unknown. Information on both child and animal abuse needs to be shared between the veterinary, medical and social care teams in order to protect both children and animals who are vulnerable.