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Abusive Head Trauma is a unique form of inflicted intracranial injury first described Caffey (1946, 1972) and Guthkelch (1971) as ‘Whiplash Shaken Infant Syndrome’, later called ‘Shaken Baby Syndrome’; AHT causes more subdural hemorrhage (SDH) in young children than motor vehicle collisions; and is the most common cause of fatal child abuse; the definition was expanded in 2009 beyond just shaking as a mechanism to take into account both contact and/or rotational injuries; The clinical presenting features include severe head injury; death; less severe trauma with an unexplained mechanism; unsuspected finding on imaging or assessment for macrocephaly, developmental delay, seizures or other neurologic concerns; or discovery during the workup as a sibling of an abused child. The clinical findings include neurologic signs and symptoms such as irritability/lethargy, altered mental status, seizures, respiratory compromise and apnea, fractures, varying degrees of pattern marks or bruises in unusual locations, vomiting and poor feeding; There have been patterns noted in child, family and perpetrator characteristics.