During 2002-2004, a total of 546,950 ED visits associated with a child aged <6 years occurred; 116,395 of these visits listed an injury as the primary diagnosis. Of these injury visits, 2,046 (1.8%) were attributed to injuries resulting from a pedal-cycle crash, accounting for an annual incidence rate of 16.7 per 10,000 population aged <6 years. Of these pedal-cycle injury visits, 1,305 (63.8%) were for a primary diagnosis of head or neck injury, and 74 (3.6%) were for a primary diagnosis of traumatic brain injury. In comparison, 682,257 visits to an ED associated with Wisconsin residents aged 6-18 years occurred; 284,127 (41.6%) were for injuries. For this older population, 13,872 (4.9%) injury visits were for pedal-cycle injuries, and 4,290 (30.9%) of the pedal-cycle injury visits had a primary diagnosis of a head or neck injury. During 2002-2004, ED charges associated with the primary diagnosis of a pedal-cycle injury for patients aged <6 years totaled $1,093,258 ($654,636 for visits with the primary diagnosis of a head and neck injury). Of the pedal-cycle injury ED visits for patients aged <6 years, 1,424 (69.6%) visits were for boys, and 622 (30.4%) visits were for girls. Injuries occurred more frequently during April-September. The youngest patient was aged 11 months, and the number of visits increased with age. Forty visits were attributed to a pedal-cycle crash with a motor vehicle in traffic; 23 of these had a head injury as the primary diagnosis. Forty-eight hospitalizations occurred (17 for head and neck injuries), with charges totaling $439,860 ($151,853 for head and neck injuries). Traffic-related motor-vehicle crashes led to a total of seven hospitalizations. During 2002-2004, no children aged <6 years died of pedal-cycle injuries.