Hypertension in the infant is uncommon and is usually associated with renal vascular or parenchymal disease, coarctation or thrombosis of the aorta, or chronic lung disease. A 3-month-old infant who presented with unexplained acute systemic hypertension was subsequently discovered to have an undiagnosed femoral fracture secondary to child abuse. Undiagnosed fractures, which are often associated with child abuse, should be considered in the differential diagnosis of an infant presenting with unexplained systemic hypertension.