This case report describes a 5-year-old child who sustained fatal craniocervical injuries as the result of an inflating automobile air bag. Although air bags have in general been shown to reduce the severity of injury to occupants of vehicles involved in front-end collisions, a growing number of incidents suggests that in some instances the air bag system itself may cause injuries, some of which can be serious or even fatal. Small children and infants in infant seats travelling in the front passenger seat appear to be particularly at risk. The increasing number of reports of air bag mediated injuries highlights the need for changes in both system design and possibly the threshold speed required for air bag deployment.