This study assessed effects of traumatic childhood death on parents. From July 1988 to September 1992, 48 of the 1,954 children admitted to our pediatric trauma center died. Interviews were requested with parents of children who died and were conducted by a chaplain in the homes of 29 parents (20 families). Interview assessments were based on Worden's "Mourning Tasks" and Demi and Miles's "Parameters of Normal Grief." Grieving was uncomplicated in seven parents (five families). Common elements included use of multifaceted non-family support networks to aid grieving, and no parents blamed themselves or God for the child's death. Grieving was pathologic in 22 parents (15 families). Dominant features included: (1) lack of a support network beyond the extended family; (2) an avoidant stance to grieving; and (3) view of God as distant and punitive. We provide nine indices that will enable hospital caregivers to anticipate the outcome of parental grieving, and offer suggestions for the physician who desires to be involved in parents' acute and rehabilitative grief recovery.