Objective: To investigate the effect of quantity and quality of early child care on children's risk for unintentional injury. Methods: A diverse cohort of 1,225 children was recruited from several sites in the United States and followed from birth until first grade. Quantity and quality of child care from birth until entry into kindergarten were used to predict unintentional injuries from age 6 months until first grade. Measures from an evaluation at 6 months of age were tested as covariates. Results: Children who spent more time in nonparental childcare environments were at slightly reduced risk for unintentional injury after controlling for child (gender, temperament), family [socioeconomic status (SES)], parent (positive parenting), and child care (quality of care) characteristics. Conclusions: We discuss possible explanations for the results, including the possibilities that childcare center environments are safer than the homes of most preschoolers or that attendance in child care is nonrandom. © The Author 2005. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved.