Purpose: This case aimed to compare the validity of fall risk assessment tools and determine an appropriate pediatric fall risk assessment tool. Methods: After a literature review dated from 2000 to 2012, we needed to establish a more efficacious fall instrument at our hospital. After we established a Grade “C” on the SIGN rating, we began a retrospective case control study. The fall risks were compared on the MFS, GRAF-PIF, and HDFS for a total of 148 cases. Results: The statistical analysis showed a mean age of 4.1 years in the fall group and 3.9 years in others(p=.996). Comparing the three instruments on sensitivity, the HDFS and the GRAF-PIF, both of which were of equal sensitivity at 86.5%, were slightly higher than that of the MFS at 83.8%. Overall, the GRAF-PIF showed the highest specificity at 64.9%, and it also had the highest percentage of negative predictive value at 93.5%. Conclusion: We can surmise that the GRAF-PIF is a superior instrument for the identification of these in-patients. In this pilot study, we identified the GRAF-PIF as the instrument of choice for conducting further clinical trials.