Paediatric minor head injuries (MHI) are just as common in both bigger and smaller towns in Malaysia. Urban-based MHI are due more to motor vehicular injuries compared to rural-based MHI which are mainly due to non-motor vehicular injuries. The main objectives of this study were to compare incidence of admitted patients to accident and emergency departments of hospitals in two different settings in Malaysia, namely: Ipoh (urban-based) and Kota Bharu (rural-based); and to correlate to demographical characteristics, types of accident, clinical signs and symptoms, radiological and computed tomography (CT) findings, management; and finally, to determine clinical predictors of intracranial injury in MHI.