Efforts to improve child restraint designs would benefit from more detailed information on how child occupants are dying in crashes. Detailed reports involving 92 children (ages 5 and younger) in child restraints who died in crashes in 2000 were obtained from police departments. Cases were reviewed to obtain basic crash information and determine the factor most responsible for the fatality. Half of the crashes were considered unsurvivable for the child, and 12 percent of fatalities were judged to result from gross misuse of the child restraint. Forty percent of all of the crashes were side impacts, and in all fatal side impact crashes there was intrusion at the child’s seating position.