In 1988, the Robert Wood Johnson Foundation supported a series of programs focused on reducing injuries to children living in low-income neighborhoods. The impetus for the initial program came from two Harlem hospital physicians who treated children for injuries from the inner-city area of New York City. The Harlem Hospital Injury Prevention Program attempted to get at some of the causes of injuries, such as unsafe playgrounds and traffic accidents. It became one of the most successful ad hoc projects in the history of the Foundation. By the end of 1992 when funding ended, there had been a 41 percent drop in major trauma hospital admissions for children living in Harlem, as compared with admissions during 1983–1987. In 1998, the program changed its name to the Injury Free Coalition for Kids and began to be replicated in other sites around the country. The author describes the expansion of the program in specific sites and takes a closer look at San Diego, Miami and Chicago.