Introduction Motor vehicle crashes are a major cause of death among the Saudi population. In Ramadan, the working hours and the road traffic rush hours differ from other months of the year; the pattern of trauma may also differ. We compared trauma in the pediatric age group in Ramadan with non-Ramadan months in terms of frequency, patterns, and severity.Methods We conducted a retrospective study, which included all pediatric trauma cases, from 2001 to 2009, who were registered in King Abdulaziz Medical City Trauma Registry. Trauma patterns were divided into two groups according to the date of occurrence: victims in Ramadan versus victims in non-Ramadan.Results A total of 3766 patients were included. The average number of trauma per month was 39.2 versus 44 for non-Ramadan and Ramadan months, respectively (P = 0.79). The mean patient age in Ramadan was 8.04 years compared with 8.07 years in non-Ramadan months (P = 0.037). Blunt trauma was the most common type in both groups. The median of the Injury Severity Score was the same and equal to 4. In both groups, neurological and vascular injuries were more common in Ramadan: P = 0.02 and P = 0.03 respectively.Conclusion There were no significant differences between trauma in Ramadan and non-Ramadan months, except for the higher percentage of vascular and neurological injuries in Ramadan.Key words: children, head injury, motor vehicle accidents, Ramadan, Saudi, trauma, vascular injur