PurposeThis article describes backpack use and incidence of back pain in children.MethodsA convenience sample of 345 children, grades five through eight, served as subjects. A written questionnaire was developed to gather information on demographics, leisure activity level, bag type, locker use, students’ perceptions of bag weight and comfort, and students’ reports of history of back pain. Scales were provided for students to weigh themselves with and without backpacks.ResultsYounger children carried proportionally greater backpack loads. Percentage of body weight by grade was as follows: fifth grade = 19%, sixth grade = 21%, seventh grade = 14%, and eighth grade = 15% body weight. Fifty-five percent of all subjects carried a load greater than 15% of their body weight, and one third of students reported a history of back pain. Percentage of body weight carried, however, was not significantly related to history of back pain.ConclusionConcerns raised by parents and professionals that children are carrying heavy loads are justified; however, the relationship between heavy carrying load and back pain needs further elucidation. Recommendations for physical therapy, backpack safety, and injury prevention are provided.