Trauma in children has been a concern but given little attention. Lately however, in Oman, it has been widely discussed in light of prevention of road traffic accidents and home accidents. Trauma in children comes only second to acute infection responsible for morbidity in children, with an annual cost of over £200 millions per year in UK.1 However, there are no cost figures from gulf countries currently available. In Oman, all limb fractures are managed in the regional referral hospitals established in all regions of the country. A good network of referral system exists for referring and transport of children from local health centers to regional referral hospitals, which are staffed by well trained specialized trauma units. There is a steady increase in hospital admission rates from accidental injuries, but there are no published data on the pattern, management and outcome of limb fractures in the pediatric age group. Keeping in mind the above mentioned facts, an audit of pediatric limb fracture at Nizwa regional referral hospital, was conducted to evaluate; a) the annual inpatient workload arising from pediatric limb fractures, b) pattern of fractures and their management, and c) areas where management could be improved. Pediatric trauma has low priority and as such has been given little attention. The aim of this study is to review and audit the pattern of pediatric fractures, their management and outcome in our local setting.