Background: Pediatric fractures constitute a significant public health concern globally, with varying implications on healthcare systems and affected individuals. While global trends have been well-documented, research in Saudi Arabia, particularly within a tertiary care setting, continues to contribute significantly to the understanding of this issue. Methods: This retrospective chart review, conducted over a four-year period from 2019 to 2023, analyzed pediatric fracture cases at a major hospital in Riyadh, Saudi Arabia. The study included 286 children aged 14 years or younger presenting with new fractures. Data on demographics, fracture types, anatomical locations, and treatment modalities were extracted from electronic health records and analyzed using IBM SPSS Statistics Version 25. Results: The study found a higher incidence of fractures in males, particularly increasing after age 8, with radial, metatarsal, and humeral fractures being the most common. Radial fractures, especially distal radial fractures, were predominant, and the majority were treated with casts and backslabs. Metatarsal fractures were more prevalent in males, predominantly treated with backslabs, while humeral fractures were more common in females, mainly treated with backslabs and slings. Conclusion: This study provides essential insights into pediatric fracture patterns in a Saudi Arabian tertiary care setting, echoing global trends and underscoring the need for conservative treatment approaches. Future research should expand on long-term outcomes, broader demographic factors, and the impact of comorbidities to enhance pediatric fracture management and healthcare strategies.

Keywords: Pediatric fracture, pediatric emergency, fracture patterns, fracture management.