Hospital charts were reviewed of all children aged 0–14 years in the Tairawhiti (Gisborne) region admitted with a serious skin infection to Gisborne Hospital between 1 January 2006 and 31 December 2007. Of the 163 documented cases, 83% occurred in Māori children. The most common types of infection were cellulitis (38%) and subcutaneous abscesses (36%), and the most frequent sites of infection were the head, face and neck (32%) and lower limbs (32%). A previous episode of skin infection was recorded in 34% of children, with previous hospitalisation in 12%. A skin injury preceded infection in 37% of cases, more than reported in the Auckland and Wellington regions. Of the 77% of children who saw a GP 60% required immediate hospital admission. Compared with figures from the Auckland region, there were longer delays to medical care with a mean duration of symptoms of 2.5 days prior to visiting a GP. The most frequently isolated organisms were Staphylococcus aureus (48%) and Streptococcus pyogenes (20%) with similar proportions and resistance patterns to other New Zealand settings.