Introduction Nonaccidental trauma is a leading cause of death and injury during childhood. In some cases, patients who experience child maltreatment and neglect may present to medical and surgical teams with different types of traumatic injuries. It is important that medical teams be diligent in recognizing signs of nonaccidental trauma in pediatric surgical patients. Purpose The aims of this study were to identify risk factors and other red flags of nonaccidental trauma and discuss different presentations of nonaccidental trauma in a pediatric surgical patient including burns, head trauma, occult abdominal trauma, and fractures. Additional discussion will include the appropriate diagnostic evaluation and reporting of suspected nonaccidental trauma. Discussion Nonaccidental trauma occurs in all types of healthcare settings. For the medical and surgical teams, it is important to maintain diligence when caring for pediatric surgical patients. In cases where nonaccidental trauma is suspected, appropriate workup and report should be completed in a timely manner and before considering the patient’s discharge from the hospital.