<p>Healthcare expenditures in the United States are among the highest in the world, and behavioral healthcare costs account for a substantial portion of overall healthcare expenses. Injuries to hospital staff contribute to the high costs associated with delivering behavioral healthcare. Interventions to decrease aggression leading to staff injuries are paramount, but there are limited data on the features of patient physical aggression resulting in these injuries. We reviewed 960 narrative reports of staff injuries caused by patient physical aggression across two pediatric healthcare systems from 2022–2024. We analyzed the putative antecedents to physical aggression, injured staff’s occupation (e.g., nurse), body part injured, and whether the injury was reportable to government agencies. Direct care staff (e.g., 1:1 staff) and nurses were at the greatest risk for injuries from patient physical aggression. Most injuries across both systems were non-reportable to government agencies. At least one putative antecedent was clear within most reports, with intrusive strategies (e.g., restraint, seclusion, and response blocking) and the presence of aversive stimuli (e.g., medical care and staff directions) being most common. Contextualizing patient physical aggression can elucidate features (e.g., putative antecedents) informing strategies to mitigate the recurrence of such behavior and, relatedly, avoid many staff injuries. These outcomes support one avenue for behavior analysts to help healthcare systems better equip staff with ways to manage their safety by better understanding patient behavior. </p>