Background: Accidents are the main cause of injury and even death in children, and more than half events happen at home. In Italy, in 2019, 12.5/1000 children/adolescents had at least one domestic accident, but only 8% of caregivers are aware of this risk. Objective: This is an Italian, observational, retrospective cohort study which evaluate which factors influence hospitalization outcome, also by considering the effect of COVID-19 lockdown. Methods: Children aged between 3-13 years receiving a visit in emergency departments (EDs) were enrolled in the study. Data were retrieved from 16 Italian paediatric EDs, by considering the period March-June 2019 and 2020. Results: In total, 8860 ED visits due to domestic accidents in children occurred before (4380) and during (4480) lockdown, of which 6.5% resulted in a hospitalization (4.7% in 2019, 8.4% in 2020). The risk of hospitalisation is influenced by the type of occurred accident, with 4.11-fold higher risk in case of poisoning and 1.75-fold lower risk for stab-wound incidents. In addition, differences were reported in the frequency of hospitalization between the two observed years (OR: 1.94; p <0.001 for 2020 vs 2019). Males had a 1.45-fold higher risk of hospitalization compared to females (p<0.001), and the risk increased with age (OR: 1.06; p<0.001). Poisoning represented the major risk of hospitalization, although it caused only 1.9% of all ED admissions, and principal causes were drugs (33.5%) and cleaning products (31.1%). Conclusions: The COVID-19 lockdown had a high impact on the risk of hospitalization, although no child enrolled tested positive for SARS-CoV-2. Regarding poisoning, a public health campaign aimed at caregivers would be necessary to minimise possible risks at home. In younger children, the ingestion of drugs may be due to the imitation of adults, while for cleaning products particular attention should be paid to colourful and easy-to-open ones.