Statement of the Problem While greatly easing the shopping process for parents, transportation of children in shopping carts also represents a hazard for injuries. Effective accident prevention measures would therefore be desirable. Methods 137 shopping cart-related accidents, the 138 victims of which presented to an Austrian Pediatric Surgical Casualty Department over a period of nine years, were reviewed retrospectively by analysis of the patient charts and of 79 questionnaires returned, correctly filled in, by the family. Results The yearly number varied between 10 and 21 without a falling trend. While 43% of the children were 2 years of age or younger, 18% were older than 4. Three-quarters of the latter had been placed inside the trolley although the maximum permitted weight is 15 kg. Falls out of the trolley comprised two-thirds of all accidents, with the child standing up as the leading cause; these were mostly falls from the basket, followed in almost 20% of cases by toppling over of the entire shopping cart. The youngest children – almost all regularly placed in the integrated seat – were at a special risk for this kind of accident, which frequently occurred in the car park. Lessons learned from the accidents were limited almost exclusively to behavioral changes implemented by the parents. Current European Standards have obviously not taken the main accident mechanisms into account, even though these have repeatedly been described in the literature. Conclusion We believe that technical improvements in the present shopping cart design are desirable to reduce the risk of accidents. Our main suggestions include: solid child seats with integrated footrests, obligatory installation and use of safety belts, and construction of trolleys with a lower center of gravity and a broader wheel base.