Accidental ingestion is an important preventable cause of childhood morbidity. All accidental ingestion presentations (n=478) to a tertiary paediatric ED from January 2010 to December 2011 were analysed. These results were compared with a similar study in the same institution ten years previously in 2001 and showed that while accidental ingestions constituted a higher proportion of presentations (0.5% in this study v 0.45% in 2001), fewer had investigations performed (21% v 35%) and fewer were admitted (7% v 20%). Accidental ingestions account for 0.5% of presentations and are an important focus of home safety information for parents and guardians. Paracetamol (n=67, 14%) and liquid detergent capsules (n=44, 9.2%) were the two most common substances implicated in these presentations, and have the potential to cause severe morbidity and mortality.