Violence toward children is an acknowledged pediatric problem, but physicians may not be aware that it is a leading cause of pediatric mortality. Therefore, I used homicide data for persons younger than 18 years of age to characterize child homicide. There are two broad categories: The first predominates until the victim age of 3 years, is intrafamilial, and is associated with bodily force and poorly defined precipitating events. It might be described as fatal child abuse. The second type predominates after the victim age of 12 years, is extrafamilial, involves guns or knives, occurs during arguments or criminal acts by the offender, and may represent children unsupervised in an adult environment. Homicides that occur in children between 3 and 12 years of age are a mixture of these two types.