This prospective descriptive study describes the referral patterns to the Red Cross War Memorial Children's Hospital. The study was conducted from 1st July to 31st December 1987 and entailed the collection of all referral letters presented (9288) to the hospital and the analysis of a sample of these letters (4702). The results indicated: * The patients are similar in terms of age and sex to those attending the Outpatients Department except that relatively fewer referred patients are Black. * The private sector, i.e. general practitioners, is the largest referral agency followed by Day Hospitals. * Most patients were ref erred to the Outpatients Department without an appointment. * Of the specialist clinics, the surgical clinics, i.e. Ophthalmology and Ear, Nose and Throat Clinics, were utilised the most. * The majority of patients (84,90%) were not admitted. * The contact made by the hospital with referral agents was poor (only in 30,30%). * The quality of information in referral letters was generally poor and did not contribute to patient care. Recommendations are made to the hospital and relevant health authorities.