This was a retrospective review of all children aged ≤16 who were treated in the casualty department at the central hospital in Lilongwe, Malawi, between 1 January 2009 and 31 December 2015. A total of 4776 children were treated for road traffic injuries (RTIs) in the study period. There was an increase in incidence from 428 RTIs in 2009 to a maximum of 834 in 2014. Child pedestrians represented 53.8% of the injuries, but 78% of deaths and 71% of those with moderate to severe head injuries. Pedestrians were mostly injured by cars (36%) and by large trucks, buses and lorries (36%). Eighty-four (1.8%) children were brought in dead, while 40 (0.8%) children died in the casualty department or during their hospital stay. There has been a drastic increase of RTIs in children in Lilongwe, Malawi. Child pedestrians were most affected, both in terms of incidence and severity.
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