Head trauma is exceedingly common in children but rarely presents as a penetrating injury to the skull. Early recognition and correct management of the possible complications of penetrating head injuries (PHIs) is important and may prevent a poor outcome. The authors' experience with 14 cases of PHIs in children referred to the Department of Neurosurgery during the last 20 years is presented. The characteristic findings on physical examination and imaging studies performed in these cases are described. All cases occurred in children in the first decade of life. There were 10 boys and 4 girls. A damaged globe that had to be exenterated was the earliest complication (1 case), followed by cerebrospinal fluid leakage (3 cases) and diabetes insipidus (1 case). Objects were removed in 11 cases. In addition to plain radiographs, computed tomography scanning and angiography were used as diagnostic procedures. The present series of patients is one of the largest collections of PHIs in children younger than 10 years of age reported in the literature. The need for prompt extrication of these objects and the possible complications of such injuries have been reviewed.