A case-comparison study was conducted of children between one and twelve years of age exposed to passenger air bag (PAB) deployment. Cases were children fatally injured by PAB exposure and were investigated by the Special Crash Investigation Program of NHTSA. For comparison, children exposed to PABs, but suffering minor injury were identified through the Partners for Child Passenger Safety (PCPS) Study, a system utilizing insurance claims data for crashes involving children.The crash severity as measured by Delta V was not significantly different between the two groups. Restraint status in conjunction with pre-impact braking highly influenced injury outcome indicating the importance of pre-crash positioning as a risk factor in child exposure to PAB deployment. Other related variables such as child size and age reinforced the importance of restraint. No vehicle characteristics or interior vehicle space measurements were significantly different between the two groups. Current vehicle designs cannot be differentiated with respect to their potential for producing serious child injuries due to PAB deployment. Researchers must continue to examine the entire spectrum of occupant injury severity in order to fully understand injury risk and ensure that future design of vehicles considers the safety of all occupants, including children.