Reducing the incidence and severity of child and adolescent injuries requires a multifaceted approach involving broad-based health and social service agencies, including schools. Recognition of the need for injury prevention education began with the Industrial Revolution in the 1900s, and safety education was developed as a unit of health instruction in the schools of the 1920s and 1930s. With the growing popularity of the automobile, concerns about traffic safety, pedestrian safety, and alcohol use and the automobile, brought about expansion of health education programs. Injury prevention and safety today are considered a content area of comprehensive school health instruction. Instruction should include attitudes toward safety, causes of accidents, home and school safety, traffic safety, fire prevention, survival education, environmental hazards, accident prevention, emergency health care, safety personnel, resources and agencies, individual safety precautions, recreational safety, occupational safety, safety rules, and laws and regulations. The content should be age-appropriate and should reflect the health problems of the nation, state, and local communities. State mandates concerning injury prevention instruction are noted, a list of barriers to effective injury prevention instruction is presented, and recommendations for program development are offered. (JDD)