Objective: To find out frequencies and types of injuries occurring in students of schools in three different Towns of Karachi and to know about the availability of medical facilities within the school premises and to give emphasizes on management and preventive measures of injuries. Design: Prospective study. Place and Duration of Study: This study is carried out in 50 schools of three different Towns of Karachi. 25 were private schools and 25 were government schools. 19 schools were co-educational schools. Schools upto higher secondary levels were chosen in this study. Minimum 750 students irrespective of sex were included in the study from each school. This study is carried out during 1st January 2010 to 31st May 2011. Patients & Methods: This study is carried out in 50 schools of three different Towns of Karachi. 25 were private schools and 25 were government schools. 19 schools were co-educational schools. Schools upto higher secondary levels were chosen in this study. Each school consists of 750 students irrespective of sex. The student's age ranges from 4 to 16 years. There were 37500 students included in this study. A self administered questionnaire was compiled by us with the help of principals, heads, doctors if available, paramedical staff if available of the schools. The inclusion criteria are proper examination and radiological evidences for diagnosis. Results: Out of 50 schools 25 were private schools and 25 were government schools. 19 schools were co-educational schools. The mean Number of students in each class was 37. 1520 students were found to suffer different types of injuries. Boys were affected 67 % while girls were 33%. Soft tissues injuries are found 65% while fractures and ephyseal injuries were found 35%. 69% of the injuries were occurred in Govt. Schools, while 31% of injuries were occurred in private schools. 87% of injuries were un-intentional, 6 % of injuries were intentional and 7 % of injuries were found corporal because of punishments of teachers. Discussion: Record keeping of injuries of the students in a school was found almost non-existent. The injured students initially should be managed in school if doctors/para medical staff are available in school, otherwise students should be referred immediately to clinic or hospital. Govt. schools were found to have very poor first aid medical services as compared to private schools which need to be improved and upgraded. The proportion of serious injuries is 1:2 minor injuries. Conclusion: School based injuries are considered insignificant in Karachi. Our study highlights the importance of significance of school based injuries and the preventive and therapeutic measures should be available in school.