Although it constitutes a large portion of investigations little is known about how child welfare workers assess harm and risk of harm in making investigation and intervention decisions in cases of supervisory neglect. Using secondary analysis of the Canadian Incidence Study of Reported Child Abuse and Neglect 2008 (CIS-2008) (n=4159), this study describes the nature and severity of injuries caused by supervisory neglect in the context of physical harm. In 2008, neglect was the largest primary category of substantiated maltreatment and supervisory neglect occurred more frequently than other types of neglect. Of the estimated cases of substantiated neglect, 44% involved failure to supervise: physical harm. Supervisory neglect cases represented 15% of all maltreatment cases, which had the highest rate of substantiation (48%) as compared to all other types of maltreatment. Within the neglect category, failure to supervise cases generally included fewer household and caregiver risk factors than did other neglect cases. Cases of supervisory neglect involved younger children and child functioning issues were less likely to be noted as a concern compared to other cases involving other forms of maltreatment. Injuries were very rare (2%) in cases of substantiated supervisory neglect, resulting in the authors’ conclusion that more information is needed about how these concerns are substantiated.