Pediatric maxillofacial injuries are of special medico-legal implications as may involve serious esthetic and functional facial problems in addition being a common occurrence in poly-trauma pediatric patients with serious implications. Aim of the study was interpretation of pediatric maxillofacial injuries from the medico-legal point of view and epidemiological analysis over a 5-year period in Assiut University Hospitals, Egypt. Methods: observational descriptive hospital-based study includes 940 patients' medical records and radiographs of pediatric maxillofacial injured cases obtained from Trauma Unit of Assiut University Hospitals in the period of 1st January 2015 to 31st of December 2019.Results: The 5-year incidence of pediatric MF injuries was 28.4% of the total MF injuries. The mean age was 8.4 ±4.5 years, with more incidence in the age group 1 to 6 years, boys represent most of the cases (72.2%). The major cause of injury was falls from height (29.1%) followed by motor-cycle accidents (22%), the manner of injury was almost always accidental (94.6%). Most pediatric MF injuries were associated with other injuries (81.36%), while only 19.64% were isolated MF injuries. Conservative treatment was indicated in 64.4% of cases while 35.6% of the cases were received surgical treatment. There was statistically significant difference between age, sex and the cause of injury, between manner of injury and its cause, between treatment modality and different age groups of the cases. In addition, there was statistically significant relation between the mean duration of hospital stay from one side and the cause of injury and the treatment modality from the other side Conclusion: Falls from height is the main etiologic factor of Pediatric Maxillofacial injuries and younger male children are more involved. Accidental manner is the usual one. Mandibular fractures are the commonest followed by fracture maxilla. Conservative management is the commonest line of treatment especially with younger age.