Firearm injuries are a serious public health problem for children and adolescents in the United States and even more of a problem in some low- and middle-income countries. A number of countries in Central and South America report extremely high rates of firearm death, though data in these countries are less reliable than data from high-income countries. Globally, there were more firearm homicides than firearm suicides among those 0–24 years old in 2016. Among high-income countries, the United States has the highest pediatric firearm death rates. It appears that a main reason for our relatively high firearm death rate is widespread firearm availability. Unfortunately, pediatric firearm injury prevention is still a topic about which little is known, not only for low- and middle-income countries but also for high-income nations. More research is needed on risk and protective factors specific to children and adolescents, and better data are needed especially for nonfatal gun injuries.