Complete skeletal survey plain radiographs are essential in the evaluation of suspected child abuse, particularly in infants and toddlers. Extracranial abnormalities are detected in 30% to 70% of abused children with head injuries. Shaken baby syndrome is described as subdural hematoma, retinal hemorrhages, and long bone fractures with minimal external signs of trauma. Due to the close association of intracranial injuries with fractures in nonaccidental trauma, both CT of the head and complete bone survey radiographs should be minimal standard imaging in any suspected child abuse case. Fractures suggestive for nonaccidental trauma can be categorized based on specificity for abuse. Subtle injuries may be missed on initial acute skeletal survey. Delayed repeated skeletal radiographs may be needed. Negative skull radiographs as part of the skeletal survey do not obviate the need for obtaining CT of the brain to investigate for intracranial bleeding or injury in suspected abuse cases.