We present a nine-year-old girl with fracture of the orbital floor and herniation of soft tissue and extraocular musculature into the maxillary sinus. A marked restriction of upward gaze was noted. Surgery was performed after two days. Herniated tissue was released and the orbital floor reconstructed. One week later she had normal eye motility. Orbital fractures of children are rare, but we stress the importance of careful clinical examination and early surgery. Due to the elasticity of the bone and lack of periorbital fat in children, extraocular musculature is more prone to entrapment in the orbital floor. The most important sign is limitation of gaze upwards. CT findings are of less importance. Early surgical management within 24 - 48 hours will reduce the risk of necrosis and fibrosis of extraocular musculature resulting in reduced eye motility.