Accidents are the leading cause of death in children and a major factor in lost productive life. This case-control study investigates childhood accidents in the home by randomly surveying children presenting to a Dublin Accident and Emergency Department. Risk factors for home accidents are examined by comparing cases (those with accidental injuries sustained at home) with controls. Of the 174 accident attenders, 59.2% were boys; 66% of all surveyed were under 5 years. Cases were more likely to belong to Social Class 5-6 (P < 0.01), their fathers were less likely to be employed (p < 0.01) and mothers were less likely to be working outside the home (P < 0.01). Over 50% of injuries were due to falls (50.8%). Blows and cuts accounted for 22.6% of injuries, while 13% were due to burns, 7.9% were due to poisoning, and 5.7% due to foreign bodies. Children under 5 were more likely than older children to have been supervised at the time of the accident. Most of the injuries were minor. However, 34 children (19.5%) required hospital admission. Measures to prevent accidents at home should be targeted towards those at most risk-parents of pre-school children and the lower social class groups. Accident prevention requires a three-pronged approach i.e. environmental change, enforcement of legislation and educational measures.