The Pediatric Trauma Score (PTS) is rapidly gaining acceptance for use in prehospital triage. This study examines its reliability in predicting mortality. The charts of the 533 trauma patients hospitalized between 1984 - 1989 were reviewed and the PTS was calculated for each. There were 3 deaths in 370 patients with PTS > 8, while 24 of 163 children with PTS less-than-or-equal-to 8 died. Size categorization was found to be overemphasized because of the low mortality (7.7%) in children smaller than 10 kg, although their mean PTS (6.4 +/- 2.1) was significantly lower than the mean PTS (9.0 +/- 2.2) of children over 10 kg. Forty-nine of 71 surgically treated patients having intra-abdominal organ injuries had a PTS > 8. The existing parameters of PTS did not have equal relationships to mortality, and may even all be inadequate in the correct triage of children with blunt abdominal trauma.