Background: There is a need for greater international understanding of student safety in schools. This New Zealand study investigated the causes and school location of fractures sustained by students attending elementary school, with special emphasis on the types of fractures sustained following falls from playground equipment of various heights. Methods: Over a 1-year period, 76 participating schools (with a combined roll of over 25,000 students) completed a questionnaire about the nature and circumstances of student fractures sustained during regular school hours. Results: Some 118 students sustained a total of 131 fractures. Injuries from playground equipment were no more frequent than those from general activities at school, and most were sustained in falls from heights less than 59 inches. Most fractures were to the upper limbs. Fractures were found to vary by gender and school size. Conclusions: The results are discussed in terms of the conditions and policies present in local schools, and the tension that exists in maintaining safety while offering appropriate challenges to students. Improvements in school safety may be more likely to result from a greater focus on the way that students interact at school, rather than on modifications to playground equipment.