Injuries from piercing or cutting instruments or objects are commonly seen in the pediatric emergency department. In this study, we present the epidemiology of piercing injuries resulting in hospitalization. Medical records for a one-year period with E-cedes 920.0-920.9 were reviewed for victim-related demographic data, anatomic injury location, vehicle of injury, treatment, and hospital charges. The Abbreviated Injury Scale (AIS) was used to ascertain injury severity. The most common vehicles of injury were glass (n = 24, 34%), nails (n = 11, 16%), and needles (n = 10, 14%). The median AIS score was significantly higher for hand injuries compared to the sample median AIS. Piercing injuries from consumer-related products were associated with the highest AIS scores (median = 2.5). Although the mean AIS for all injuries was only 1.5, these injuries resulted in significant costs, with a mean hospitalization charge of $3884 ± 3528. Surgical procedures under general anesthesia were required in 81% of the patients.