Authors review the usefulness of radiographic skull examination in childhood head injury. Two hundred and forty-two patients assisted at the emergency area were prospectively recorded during one year. Data of filiation and epidemiology and symptoms and signs posed by Leonidas as "high risk criteria" to have a skull fracture, were registered. AP and L X-Ray skull were performed in all patients. Thirteen (5.37%) of them had a fracture. Blood discharge from the ear and skull depressed fracture were more frequently found in the fracture group with statistically significant difference (p less than 0.05 and p less than 0.01, respectively). The probability of positive finding was 8.8 for blood discharge from the ear, 17.6 for skull depressed fracture and 4.4 for bilateral black eyes. Because of no correlation between clinical and radiological findings, the radiographic skull examination must be systematically performed in every head injury if the purpose is to diagnose a fracture.