OBJECTIVE: We sought to characterize injuries and outcomes from terror explosions with specific attention to children (0-10 years) and adolescents (11-15 years) compared to adults (16-45 years). SUMMARY BACKGROUND DATA: Terror explosions target vulnerable populations and result in multidimensional injuries that may vary according to age group. The relative dearth of information regarding terror-related injuries among children inhibits proper preparedness and optimum management during such an event. METHODS: A retrospective study was performed using data from the national Israel Trauma Registry (October 2000 to December 2005). Included were civilians and nonactive military personnel hospitalized as a result of a terror explosion. RESULTS: During the 5.3-year study period, 49 children (0-10 years), 65 adolescents (11-15 years), and 723 adults (16-45 years) were hospitalized from terror explosions. Children were more likely than adults to sustain severe injuries (27% vs. 12%) and traumatic brain injury (35% vs. 20%) and less likely to sustain injuries to their extremities (35% vs. 57%) or open wounds (39% vs. 59%) (P ≤ 0.05). The adolescent injury profile was similar to that of adults, however, adolescents presented with less internal injuries, more contusions, and superficial wounds to extremities and were more likely to require surgery for mild to moderate wounds. Differences in hospital utilization and outcomes by age groups were observed when data were stratified by injury severity. CONCLUSIONS: Compared to adults, children, and adolescents exposed to terror explosions present with different injuries and hospital utilization and outcomes. These results further confirm that preparedness of a pediatric healthcare system is essential for effective management in the event of a future mass casualty incident.