Trauma accounts for a high percentage of unexpected deaths in toddlers and young children, mostly due to vehicle accidents, drowning and fires. Given recent efforts to publicise the dangers of toddler run-overs a study was undertaken to determine how significant this problem remains in South Australia. Review of coronial files over 7 years from 2000 to 2006 revealed 50 cases of sudden and unexpected death in children aged between 1 and 3 years of which 12 of 28 accidents involved motor vehicles (6 run-overs and 6 passengers). The 6 children who were killed by vehicle run-overs were aged from 12 months to 22 months (ave = 16.8 months) with a male to female ratio of 1:1. Four deaths occurred with reversing vehicles in home driveways and one at a community centre. The remaining death involved a child being run over at the beach by a forward moving vehicle. Vehicles included sedans in four cases and a four-wheel drive in one case (one vehicle was not described), and were driven by the victim’s parent in four cases, a friend of the family in one, and an unrelated person in the final case. Deaths were all due to blunt cranial trauma. Despite initiatives to prevent these deaths, toddler run-overs in South Australia approximate the number of sudden deaths due to homicides, drownings and natural diseases, respectively, for the same age group; deaths are also occurring in places other than home driveways, and sedans were more often involved than four-wheel drive vehicles.