Autopsies performed over five years at one referral hospital in New Delhi, India, on children less than 13 years old dying from polytrauma were reviewed. Of 184 autopsies studied, traffic related events and falls were the commonest injury mechanisms. Head injury caused death in 68%, and shock, multiple injuries or sepsis in the rest. Four peaks in the number of deaths from the time of the precipitating event were noted. Sixty-four of the deaths were preventable, and 60 possibly preventable. The majority of these could have been salvaged by following established principles in trauma management. Bias towards preferential treatment of males was absent.