Introduction The prevalence of epinephrine auto-injectors (EAI) use is on the rise. Methods This case series describes four children with hooked EAI needles that were embedded in soft tissues. Results Two children (ages 5 and 7) who were curious about EAIs self-injected in their shins. The EAIs embedded beneath the skin and required removal in the Emergency Department. On removal, the needles were both hooked and splayed at the tip. A 16-month-old boy in anaphylaxis kicked his leg during EAI injection and the hooked needle embedded under his skin. A 4-year-old girl had an EAI administered for anaphylaxis, which was difficult to dislodge. On removal, the needle tip was hooked approximately 160 degrees. Images of the device revealed that the needle fired off-center from the device and the device components were cracked. We propose three different explanations for these hooked EAI needles. The first is that the needle could hit bone during injection and curve rather than penetrate further. Secondly, the needle could bend when the patient moves during injection. Thirdly, if a needle fires sufficiently off-center to hit the cartridge carrier, this could hook the needle prior to injection. Conclusions Awareness of the reasons for needle hooking, the needle damage observed, and challenges and successful approaches to their removal, can better prepare the provider for these uncommon events. Teaching parents, children and educators about safe EAI storage and appropriate restraint during use may prevent some of these accidental injuries. Reporting device failures may lead to improvements in device performance and design.