Child abuse is common, and identifying child abuse can be challenging. The history can be false, the physical findings can be subtle, and missed cases can lead to lifelong individual problems and widespread societal problems. The ED visit is one opportunity for someone to stop the ongoing abuse. This is one of the rare instances in which prevention can be successfully performed in the ED. By maintaining an openness to the possibility that young children may have been physically abused, regardless of the chief complaint, emergency physicians can have a powerful impact on the lives of many children.