Objective—To measure the incidence of childhood fractures in a defined population. Setting—Accident and emergency (A&E) departments covering the Swansea and Neath Port Talbot areas of South Wales in 1996. Methods—Linkage of data from A&E departments with population data to produce fracture incidence rates by anatomical site and cause in children aged 0–14 years. Results—During 1996, 2463 new fractures occurred in 2399 residents yielding a fracture rate of 36.1/1000 children. Fractures were more common in boys than girls and increased with age in both groups. Sports and leisure activities accounted for 36% of fractures, assaults for 3.5%, and road traffic accidents 1.4%. Fractures of the radius/ulna were most frequent (36%). Conclusions—The fracture rate in South Wales children is twice the rate reported in previous studies. Further research is required to elucidate the reasons behind this high rate. Many fractures could be prevented by the use of safer surfaces in school playgrounds, and wrist protection in in-line skaters and possibly in soccer players.