As more children move to the rear rows, there is a need to understand the rear impact environment for children to guide future regulatory and due care activities in this impact direction. A probability sample of 1,035 restrained child occupants, aged 0-12 years, seated in a second row outboard position in rear impact tow-away crashes, weighted to represent 10,079 children, was collected from an on-going child specific crash surveillance system between 3/1/00 and 12/31/06. These data were analyzed to quantify the overall injury risk and the influence of both front seat occupant presence and reported front seat back deformation on injury risk. Overall risk of AIS 2+ injury for restrained child occupants seated in the rear row outboard position in rear impact crashes was 2.3%. Occupants were seated in front of these children in 71% of cases and deformation of the front seat back into the child's space was reported in 8% of cases. For those children with seatback deformation occurring directly in front of them, there was a doubling of the injury risk (4.8% vs. 2.1%, adjusted OR=2.4, 95% CI=1.2-4.8). This paper provides the first population-based estimates of the injury risk of rear row-seated children in rear impact crash events and points to the importance of understanding the role of front seat back design on rear impact injury risk for both the front seat and rear seat occupants.