Head injuries are the most common cause of disability and death in children. Identification of children who require specialized management following a head injury will reduce the associated morbidity and mortality. Thus, it is important to differentiate the child who can be safely observed and who will recover spontaneously from the child who will develop a progressive neurologic deficit from a treatable cause. A thorough history, a tailored neurologic examination and limited radiographic studies will assist the family physician in making this determination.