BACKGROUND: Asthma is the most common chronic illness in American children. Injury is the most common acute medical condition and also the leading cause of mortality. Previous research examining possible links between pediatric asthma and injury is inconclusive. OBJECTIVE: This study investigates the relationship between pediatric asthma and injury. METHODS: Asthma diagnosis and multiple child, parent, and family characteristics were assessed from 878 families when children were 54 months. Parents reported child injuries regularly over the next 2.5 years. RESULTS: Children with asthma had more injuries than children without asthma, even after controlling for child, parent, and environmental covariates. CONCLUSIONS: Four-year-old children diagnosed with asthma appear to have increased risk of injury over their peers as they enter the early elementary school years, and the authors discuss the possible causes of this relationship.