Traumatic injuries represent the most important threat to the health of children in the United States and are the leading cause of death after the first year of life. More than 20,000 children and young adults will die this year as a result of injury. For every child that dies, another 40 will require hospitalization and 1000 more will be evaluated in emergency departments. Moreover, 50,000 children and adolescents will sustain some degree of permanent disability, the majority of victims of brain injury. This article focuses on several important long-term implications for children, their families and primary care physicians, following multisystem injuries.