Introduction Cyclists have a high mortality and morbidity per mile travelled compared with car occupants, a figure that is likely to increase if campaigns to increase active travel are successful. Concerns about safety is the leading factor limiting cycling for children.

Objective This review brings together a paediatric perspective based on the developmental readiness of children and young people and a public health approach to reducing injuries, to produce a practical agenda for improving the safety of cycling for children.

Method Selective literature review.

Results While most sports realise the importance of practice and training to create mastery of the game, similar thinking has not been consistently applied to cycling proficiency, so many children do not have an opportunity to master cycling before riding on the roads.

Conclusions The aim should be to minimise road traffic injuries involving children and young people in ways that create cobenefits for other members of society, increasing opportunities for active travel, reducing air pollution, creating more green space to play and reducing dependence on motor vehicles.

Changes in legislation are required now to enable younger children to cycle on pavements while learning to ride and improvements in road design to separate cyclists from motor vehicles especially routes to school for older children.