While it has been shown that non-parental child care is associated with a reduced risk for unintentional injuries, a considerable number of accidents in kindergartens do result in severe injuries. We have collected data on the behavioral and environmental aspects of accidents that occurred in kindergartens in Austria with the aim of determining possible prevention measures. Included in the study were all kindergarten-related injuries (347) from among 21,582 pediatric trauma cases treated in a 22-month period in Graz, Austria. Kindergarten-related injuries that were treated during the same period at six participating hospitals located throughout Austria were used for comparison. A questionnaire was completed at first attendance, and additional information was achieved by interviews with the parents and kindergarten teachers. Only the 347 kindergarten accidents that occurred in Graz were analyzed in detail. Half of the injuries occurred in an outdoor environment (outside), even though most of the time was spent indoors. Boys were more frequently involved in accidents than girls (male:female=3:2). We identified seasonal and circadian differences, with most children being injured during the first 2 months of attendance (September and October), during the first 3 days of the week (Monday to Wednesday) and in the hour before and after lunch, respectively. Of the 347 accidents analyzed, 24% resulted in serious injury, and injuries occurring outdoors were more severe than those occurring indoors. Most parents felt that the accidents were unpreventable (47%), while 18% stated that improved supervision may have prevented the accident. Kindergarten accidents in Austria still result in a significant number of severe injuries. Kindergarten injuries were related to gender, season, time of day and location. Our results indicate the necessity of a continuous child safety training program that involves the participation of all teachers in day-care functions.