The aim of the present study was to study the epidemiological and clinical profile of patients attending an exclusive pediatric Emergency Department (ED). Data was retrieved from records of the patients seen over a 6-year period from 1995 to 2000. Descriptive analysis was done to define demographic and clinical details, and monthly admission rates and diagnoses. A total of 43800 patients were seen during the study period. Of these 42.1 per cent were admitted after initial evaluation. The ratio of boys to girls was 3:1; 47 per cent were infants under 1 year of age. The common reasons for attending the emergency department were gastrointestinal and respiratory illnesses (23 per cent each), neurological emergencies (16 per cent), and neonatal problems (15.6 per cent). Poisonings were seen in 0.6 per cent of patients. Eight illnesses, i.e. acute diarrhea, upper respiratory infection, pneumonia, acute asthma, seizures, meningitis, and neonatal sepsis and jaundice, comprised nearly half of all the emergency visits. Acute diarrhoeal diseases, pneumonia, asthma, and encephalitis showed a distinct seasonal trend. Our data implies that planning of staff training and triage and efficient resource utilization in the pediatric ED in a developing country such as ours should take into consideration the preponderance of infants, seasonal trends, and the most common emergencies (acute diarrhea, pneumonia, acute asthma, seizures and neonatal infection) as priorities.