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Background Drowning is the third leading cause of death worldwide (WHO, 2010). According to Brenner et al (2009) participating in swimming lessons (SL) can reduce by 88% the risk of drowning in children 1-4 years old, despite some controversy regarding the most appropriate swimming programs (Ward, 2009). On the other hand no studies tested the skills acquired in SL in drowning prevention. So we proposed a test to evaluate the survivability of a child that accidentally falls into the water. Methods Twenty two children (4.68±0.82yrs) who practice SL (2.01±0.91yrs/practice) were subjected to two tests: aquatic readiness (AR) (Stallman et al, 2008); and survival test (ST), which consisted of an inflatable boat ride (unknown pool; presence of the usual swim teacher; wearing t-shirt) which 'accidentally' turns. Recorded images were later observed by 6 field experts whose observations obtained an overall index of concordance (IC) of 89%. Results In ST 15 children had positive responses (n=10, 100% IC; n=1, 66% IC; n=1, 83% IC; n=3, 50% IC) and 7 (n=6, 100% IC; n=1, 66% IC) would be in danger. Conclusions Through this test, we found that not all children whose result was positive in AR had a positive performance in the ST. This brings us to observe according to Langendörfer (2011) that the positive or negative response of the subject depends on the interaction of various constraints such as individual characteristics, the environment conditions, and the state in which the swimmer is. The application of ST suggests that the inclusion of safety and prevention activities in swimming lessons, aiming to develop attitudes and motor skills as a defense to drowning, must be taken into account. More studies are necessary to provide valid information to assist pediatricians in advising parents regarding what type of SL are more appropriate to reduce drowning. [ABSTRACT FROM AUTHOR]