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Firearms recently became the number one cause of death for children in the United States, surpassing motor vehicle deaths and those caused by other injuries.We examine how gun violence and other types of firearm deaths among children and teens in the United States compares to rates in similarly large and wealthy countries. We select comparable large and wealthy countries by identifying Organization for Economic Co-operation and Development (OECD) member nations with above median GDP and above median GDP per capita in at least one year from 2010-2020. Using the Centers for Disease Control and Prevention (CDC) Wonder database and the Institute for Health Metrics and Evaluation (IHME) Global Burden of Disease (GBD) study data, we compare fatality rates and disability estimates for people ages 1 through 19. (Since estimates were not available for children ages 1-17 alone, young adults ages 18 and 19 are grouped with children for the purposes of this brief).We find that the United States is alone among peer nations in the number of child firearm deaths. In no other similarly large or wealthy country are firearm deaths in the top 4 causes of mortality let alone the number 1 cause of death among children.