This study analysed epidemiological data from 351,440 paediatric emergency department (ED) visits to an Australian and New Zealand research network (i.e. 11 sites of the Paediatric Research in Emergency Departments International Collaborative [PREDICT]) in 2004. Mean patient age was 4.6 years and 55% were boys. Presentations were identified as 3% Aboriginal at Australian sites and 44% Māori/ Pacific in New Zealand locations. According to the Australasian Triage Scale (ATS), 5% were ATS 1 or 2 (to be seen immediately or within 10 min), 27% ATS 3 (to be seen within 30 min) and 67% ATS 4 or 5. Although ED visits peaked in late winter and early spring, admission rates remained unchanged throughout the year with an overall admission rate of 24%. Most frequent diagnoses were acute gastroenteritis, acute viral illness and upper respiratory tract infection. Asthma was the next most common.