OBJECTIVES: To assess the characteristics of assumed accidental ear injury in children. METHODS: A prospective survey of 111 children presenting with accidental external or internal ear injuries to a paediatric accident and emergency department. RESULTS: The majority of patients were male (73%). Right and left sided injuries were equally common (51% right, non-bilateral). Presentation with accidental ear injury was very rare in children under the age of 1 year (n=1). Most patients were self referred (98%), and presented within six hours of injury (84%). The mechanism of injury was variable, but cotton bud induced injury was common (7%). The most common injuries were lacerations of the pinna, in 63 patients (56%). Fourteen per cent had blood in the external canal. Only three patients required admission. CONCLUSIONS: Lacerations are the commonest form of accidental ear injury. Ear injuries that are bilateral and in children less than 1 year of age are rare and may suggest non-accidental injury. Cotton bud induced injury is common and preventable.