Background <p>Dilated fundus examination is the clinical reference standard for retinal hemorrhage diagnosis. Obtaining a timely examination may be challenging in emergent and inpatient settings, and retinal hemorrhage may go undetected. An imaging biomarker is therefore desirable.</p> Objective <p>To evaluate the frequency of ringlets of hyperintensity in orbital fat on axial fat-suppressed T2-weighted fast spin echo MR images in children with ophthalmologically-confirmed retinal hemorrhage and in a comparison group of children with benign macrocrania.</p> Materials and methods <p>This retrospective single-center study included cases aged &gt; 6 weeks- &lt; 3 years with ophthalmologist-confirmed retinal hemorrhage from 07/2011–12/2019 who underwent full brain MR imaging and reference patients aged &gt; 6 weeks- &lt; 3 years with benign macrocrania who underwent brain MR imaging during the same period. Images were reviewed by two pediatric neuroradiologists blinded to patient group; a subset was randomly selected for duplicate reads. Descriptive data were tabulated for each reviewer and adjudicated results.</p> Results <p>After adjudication, ringlets were observed in at least one eye in 67/70 retinal hemorrhage cases (96%) and 3/74 benign macrocrania patients (4%; <i>P</i> &lt; 0.0001). Similar results were observed upon stratification by presence of visible retinal hemorrhage on imaging, and by magnet strength. Intrarater reliability and interrater reliability were high (all <i>κ</i> ≥ 0.86), with concordance rates ≥ 93% across duplicate reads.</p> Conclusion <p>Ringlets of hyperintensity are present at high frequency in children with confirmed retinal hemorrhage and are neither an MR imaging artifact, nor a normal developmental finding in infants and young children. As such, they may aid in retinal hemorrhage detection following abusive head trauma.</p> Graphical abstract <p></p>