Motor vehicle collisions are the leading cause of death from injury during childhood. As children outgrow their toddler car seats, they are often restrained by two-point lap belts, which are fashioned for adult body proportions. Those children restrained by two-point lap belts are at risk for intraabdominal and spinal injury during an auto collision. This article explores the mechanisms of injury and identification of “lap belt syndrome.” Aspects of nursing care and prevention strategies will be discussed. A case study illustrates and summarizes the cogent aspects of lap belt related injury and child/family care.