Around 1 in 6 of the world s children live in a conflict zone, and of these 357 million children, 165 million are affected by high intensity conflicts. Pediatric war injuries pose a huge challenge to health professionals treating such patients. The evidence base on the quality and scale of this challenge is scarce, and the majority of clinicians treating these patients are either not sufficiently experienced in the treatment of war injuries, are not pediatric surgeons, or both. The majority of the evidence in the literature comes from a small subset of children who were managed in well-resourced military facilities that differ drastically from the conditions in which the majority of war wounded children are treated.