Background and objective: Child mortality rate is an important health index affected by many socioeconomic factors and reflects countries development and status. Autopsy in cases of children death is beneficial for Forensic medicine and medical research purposes. Children autopsy is conducted in the case of unnatural children deaths especially in the age group under 19 years of age. Similar to adults, trauma is the major cause of death in children, however it is important to identify other causes and age distribution of deaths. A study done in Pakistan showed that road traffic accident, poisoning and drowning accounted for 67% and 18% of children deaths respectively. The aim of this study was to describe frequency and pattern of unnatural deaths during childhood and adolescence in Great Cairo during a period of one year. Materials and methods : In one year period ( from 1 January 2016 till 30 December 2016 ) , all medico-legal childhood deaths aged 0–20 years were investigated under the auspices of Forensic Medicine authority , and were retrospectively reviewed (n = 182). This number of cases represents 11.7% of the 1562 forensic autopsies performed during one year. Age, gender, cause and manner of death, autopsy findings, type of abuse and laboratory investigations were analyzed. Results: From this study we concluded that the total number of child deaths during one year period in the Great Cairo was around 182 cases. More than 50% of cases were males in the 2nd decade, the perpetrator was not related to the victim in more than 70% of incidents, 70% of cases showed physical abuse. Male children deaths were mainly of homicidal or accidental nature, while females were of suicidal nature. Weapons related deaths in males were mainly blunt, sharp or firearm, while in females it was either poison or burn. 50% of cases with +ve toxicologic lab findings showed elevated Co levels followed by drugs of abuse. Conclusion: Urgent attention is required to be taken towards the problem of injury and violence against children and adolescents occurring through the world.