BACKGROUND Penetrating eye injuries remain an important cause of blindness among children. METHODS Thirty consecutive children, nine years of age or younger, were treated for penetrating eye injuries. Twenty-two (73%) of those patients studied were male and 8 (17%) were female. The average age of the patients was 4.6 years. Sharp objects accounted for the majority of injuries (83%). Twenty (66%) eyes required only primary repair and 10 (33%) eyes required secondary lensectomy and vitreous surgery, which was done within 10 days of the primary repair. Length of follow-up ranged from 6 months to 48 months, and 5 patients were lost to follow-up. RESULTS Visual acuity of 20/40 or better was achieved in 13 (72%) of the 18 patients requiring only primary repair. Stereopsis was present in 13 (87%) of these patients. Of those patients that underwent secondary lensectomy with anterior or pars plana vitrectomy, 42% had visual acuity of 20/100 or better. None had stereopsis. CONCLUSIONS Young children with penetrating eye injuries requiring only primary repair may achieve excellent visual recovery, whereas those with traumatic cataract necessitating lensectomy and vitreous surgery have a less favorable outcome because of more severe injury and subsequent amblyopia.