Determined the prevalence and predictors of posttraumatic stress disorder (PTSD) in children after hospitalizations for accidental injuries. 48 7-17 yr olds and their parents were assessed during hospitalization with measures of children's prior traumatization, prior psychopathology, injury severity, parental acute distress, and child acute distress. At outpatient followup at least 1 mo later, children were evaluated for current PTSD diagnosis and PTSD symptomatology (PTSDS) by a child structured interview and for PTSDS by a parent questionnaire. Results show that a total of 12.5% had the full syndrome of PTSD at followup, and an additional 16.7% had partial (subsyndromal) PTSD. Full PTSD was associated with a higher level of prior psychopathology, higher parental acute distress, and higher rates of prior sexual abuse, compared with partial or no PTSD. Prior psychopathology, parental distress, and, children's acute distress as reported by parents and breadth of prior traumatization, predicted subsequent PTSDS. It is concluded that full or partial PTSD is relatively common in youths 1 mo or more after hospitalization for injuries. Parents' acute distress and children's prior psychopathology, prior traumatization, and acute distress may be useful predictors of such injured children's subsequent PTSD or PTSDS.