Abstract Aims To determine the prevalence of hepatic steatosis in a cohort of previously healthy children and adolescents, with the use of abdominal computer tomography (CT). Methods Retrospective review of the Sickkids trauma database from (year 2004 to 2015). Inclusion criteria: previously healthy children ages 1-17yr having undergone an abdominal CT scan as a part of routine trauma assessment. Exclusion criteria: Involvement of spleen and/or liver in the injury, known metabolic condition, concurrent use of medications that could predispose to hepatic steatosis. Steatosis was defined as a liver spleen attenuation index (L/S AI) of <0.8. Anthropometrics and baseline demographics were collected. Statistical analyses were performed using Graphpad Prism 7. Results A total of 143 children were included in the analyses with a mean (SD) age of 7.12(4.26) years. 88 children were male (7.10(4.24) years old). The mean (SD) weight z score was 0.48 (0.97). Fifteen percent of the 137 children with a weight z-score between -2 to 2 had evidence of hepatic steatosis on imaging (using liver/spleen index <0.8). Twenty seven percent (6/22) of children with weight z-scores less than the 33rd percentile had L/S AI <0.8. An inverse correlation between weight z-scores and L/S AI was found in children >10 years (P<0.016) (Fig 1); however there was no correlation in pre-pubertal children (P<0.374). Conclusions Hepatic steatosis is highly prevalent in this cohort of healthy children in Ontario. Larger population based studies are needed to investigate the prevalence of hepatic steatosis in children across Canada. Funding Agencies None