The purpose of our study is to identify specific factors that affect a child's ability to attend school after an acute orthopaedic injury. One hundred and sixty-four school-aged patients receiving treatment for an acute orthopaedic injury at the Division of Pediatric Orthopaedics were interviewed along with their parents. Most participants were Hispanic, which reflects the population of the Washington Heights section of Manhattan served by our hospital. Follow-up telephone interviews were conducted with those parents whose children were unable to return to school. The parents were asked of both the total number of school absences and whether the child received home instruction. A survey regarding official school attendance policy was mailed to the principals of all the schools attended by the children in our study. Forty-seven percent of the children were unable to return to school immediately after their injuries. Nearly 70% (n = 51) of the children who did not immediately return to school attributed their nonattendance to their school's attendance policy. Only half of the absentees received home instruction. A multivariate analysis showed that both the type of school (public vs private) and the use of crutches were statistically significant risk factors for school absence. The median household income also trended toward significance in predicting school attendance. The responses to our survey regarding official school attendance policy demonstrated considerable variability among the schools. This study indicates that pediatric orthopaedic injuries and their treatment impact the ability of school-aged patients to attend school. Our study shows that children's socioeconomic background influences their ability to attend school while injured.