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Objective. To determine whether left-handedness is a risk factor for unintentional injury among children and adolescents.Case-control study.Pediatric emergency department of Arkansas Children's Hospital.265 patients sustaining unintentional trauma aged 6 to 18 years and 494 control patients who did not have trauma were given a questionnaire to determine handedness, past unintentional injury, and parental perception of injury proneness.The frequency of left-handedness in the trauma group (18.1%) was significantly greater than frequency of 10.5% in the control group (P < .003, odds ratio = 1.80, 95% confidence interval 1.20 to 2.72). Multivariate analysis revealed handedness as the only significant variable between trauma and control (P < .04). The proportion of left-handers who had been hospitalized previously for injury treatment (20.0%) was larger than the proportion of right-handers, (12.0%) (P < .026, odds ratio = 1.84, 95% confidence interval 1.03 to 3.27). More parents of left-handers rated their child as "more clumsy than average" than parents of right-handers (26.0% vs 15.2%, P < .007).Left-handedness appears to be a risk factor for unintentional injury in children and adolescents in a pediatric emergency department population. Pediatrics 1993;92:823-826; left-handedness, unintentional injury, laterality.