An epidemiologic analysis was performed of workers' compensation data in an effort to determine the distribution, determinants, and health consequences of occupational injury among adolescents working in New York State. Data was obtained from the New York State Workers' Compensation files for 1980 through 1987. During this time period a total of 9,656 work related injury awards were made to adolescents with an average number of 427,578 adolescents employed each year. The injuries included an average of one death per year for 14 to 15 year olds and three deaths per year for 16 and 17 year old workers. The total number of deaths in this period was 31. For 16 and 17 year olds the injury award rates were three and six times higher, respectively, than those made to 14 and 15 year olds. Males and females were almost equally represented in the adolescent work force. However, at every age level the injury awards made to males exceeded those made to females by three to one. The highest overall rates of work related injury awards were made in the manufacturing and agricultural industries. The trade sector had the third highest injury rate, 33.2 per 10,000. The service industry was the second largest employer of adolescents, and had the low injury rate of 16.0 per 10,000. Unskilled labor had the highest injury award rate of all major occupational groupings. Of the 9,656 adolescent occupational injuries suffered, a high proportion, 43.8%, suffered permanent disability, including lacerations, amputations, fractures, dislocations, multiple injuries and gunshot wounds. The needs for additional education and stronger legal measures to protect these young workers are addressed. The authors conclude that occupational injuries are a substantial and underrecognized contributor to the continuing epidemic of injury among adolescents and suggest approaches to prevention in the areas of research, data collection, education, and legal measures.