Injury accidents, which are the leading cause of death for children over 1 year of age, are often preventable. In addition, many health problems of childhood and adulthood are considered alterable if intervention is started early. These two factors have made health and safety promotion key issues for the national health agenda. Knowledge about health and safety is gained throughout childhood, yet little is known about the content and sequence of learning that takes place during the preschool years. The purpose of this research was to develop and test an instrument that assesses health and safety knowledge using a picture format. The instrument was used with 206 children ages 36 to 71 months. The findings suggested that young children rapidly gain health and safety knowledge and that the preschool years are an important time for nurses and other health care professionals to incorporate health-promoting behaviors into children's lifestyles.