Purpose: Playground slides continue to be a popular apparatus for childhood play and a frequent cause of childhood injury. Few studies have examined the mechanisms and injuries associated with slide-related injuries in the preschool child. The purpose of this study was to better understand the factors associated with slide-related injuries in young children. Methods: Playground slide injuries in children 5 years of age and younger from 2002-2015 were identified (N=12,686) using the National Electronic Injury Surveillance System (NEISS), a system that prospectively collects injury data from a stratified sampling of emergency departments from across the nation. Those injured were categorized by age, and descriptive and comparative analyses were performed. Results: An estimated 352,698 children less than 6 years of age were injured on slides in the United States during the study period. Overall, 59% were male. The age group with the highest percentage of injured children (22%) was 12-23 months. Significant differences among various age groups were noted by sex and race of patient, injury diagnosis and affected body part (all p < 0.001). The most frequent diagnosis was a fracture (36%) which may be underestimated due to occult fractures, especially of the tibia (Toddler’s fractures). Lacerations were 19% of the injuries. Overall, the affected body part was the lower extremity in 26% of those injured. The younger the age group of the child, the higher the percentages of injuries involving the lower extremity and of children noted to be on the lap of another person at the time of the injury (both p < 0.001). For narratives mentioning that the child was on a person’s lap, the injuries involved the lower extremity in 94% (577/614), with the vast majority involving the lower leg (tibia). Conclusions: The majority of injuries sustained on slides by infants and young toddlers are lower extremity fractures and sliding down on another person’s lap is the primary cause of these injuries. Parents should be aware of the risk that a child’s lower extremity can catch the side of a slide when going down on a person’s lap, and that the potential twisting force on the child’s lower extremity may cause a tibia fracture. We recommend that young children not go down a slide on another person’s lap. Families should be counseled that if they elect to do so, extreme caution is necessary to avoid the child catching their foot on the slide surfaces.