BACKGROUND: The purpose of this study is to provide nationally representative estimates of children visiting hospital-based emergency departments (ED) for motor vechicle traffic accidents (MVTA) in the United States during the year of 2008. METHODS: Nationwide Emergency Department Sample for 2008 was used. All pediatric (age ≤18 years) ED visits with external cause for injury ICD-9-diagnostic codes for MVTA were selected. Outcomes examined included discharge status following ED visit and presence of concomitant injuries. Descriptive statistics was used to summarize the estimates. RESULTS: Totally 604 027 hospital-based ED visits occurred in the United States among children (age ≤18 years) due to MVTA. Following an ED visit, 91% were discharged routinely, while 6% were admitted as inpatients into the same hospital. A total of 928 children died in the ED. A total of 34 004 ED visits required inpatient admission into the same hospital and 768 patients died during hospitalization. Mean charge per ED visit was $1887 and total ED charges across the United States were close to $970 million. Among those admitted into the same hospital following ED visit (n=34 004), the mean hospitalization charge was $53 726 and total hospitalization charge across the entire United States were $1.8 billion. CONCLUSIONS: Study findings illustrate the burden associated with pediatric ED visits due to MVTA. Close to $970 million of hospital charges were incurred by children who made an ED visit due to a MVTA during 2008 and about $1.8 billion was incurred among those hospitalized following an ED visit.