Drowning is a leading cause of death in children. Each year there are thousands of injuries in children, some fatal, associated with aquatic adventure sports. Personal water craft rapidly accelerate children to high velocities, as does being towed behind boats on skis or tubes, whereupon children have no control of their speed or direction. Canoeing and white-water kayaking particularly stress the upper limbs and shoulder dislocations are a primary concern. Surfing and kite-surfing generate more injuries to the head and face than other parts of the body and, in scuba diving, children most frequently injure their ears due to the acute pressure changes experienced. Aquatic injuries cost more in children than in adults and residual functional deficits may last a lifetime. There is a pressing need for research into the prevalence and incidence of aquatic injuries in children, so the effectiveness of preventive interventions can be determined.