At least three million children under the age of six know nothing but war. For many Syrian children, prolonged exposure to war, stress and uncertainty has left them in a state of “toxic stress.” Some of the immediate impacts of this stress are increased bedwetting, self-harm, suicide attempts and aggressive or withdrawn behaviour. Left untreated the long-term effects may be even greater. Save the Children has completed the largest and most comprehensive study of Syrian children’s mental health and well-being. This 25-page report documents the impact of war on children and their families and ends with recommendations for creating solutions.