The object of this study are transport vehicle accidents (ICD-E Code 800 to 829) in children and adolescents. During the years 1980 through 1989 there were 3660 such casualties in persons under 20 years of age in Austria. The investigation is based on data available on death certificates. The mortality rate (per 10,000 child years) for pedestrians was 0.20, for pedal cyclists 0.06, for motor cyclists 0.35, and for others (mostly car occupants) 1.19. For older teenagers (15 to 19 years old) these rates were 0.23, 0.06, 1.12, and 3.25, respectively. The male to female ratio was 3.26:1. Subgroup-analysis of pedestrians revealed a difference in injury pattern due to different body proportions: the ratio of head injury deaths to spine injury deaths was 3.7:1 in children less than 10 years old, but 11.6:1 in teenagers. In this latter age group head trauma was more common an injury leading to death in pedal cyclists than in motorcyclists (79%:66%). It is worthwhile to recommend and promote the use of bicycle helmets. However, the problem with bicyclists is rather small compared with that of the motor-vehicle related mortality of adolescents.