Current evidence suggests that the majority of injured children are not treated in a pediatric trauma center. This review failed to provide a definitive answer to the question of whether injured children treated at children's hospitals or adult hospitals with a dedicated pediatric unit have better outcomes than those treated at adult hospitals. However, it identified areas that have been addressed, and more importantly, uncovered others that are largely unanswered. In lieu of a prospective randomized trial, the next best way to address these unsolved issues would be a prospective collection of data with careful attention to assessing injury severity, physiologic response to the injury, associated injuries and comorbidities, along with resuscitation techniques, hospital resources, and manpower training.