Hanging injuries and fatalities are rare among children and are usuall
y unintentional. In this report we describe a 23-month-old girl who al
most died when she accidentally hanged herself with a popular toy neck
lace, and we discuss recent epidemiological trends in accidental stran
gulations among children. This case emphasizes the need for increased
awareness among consumers, health care providers, and product manufact
urers about the dangers of toys such as the one described here.