MSc, Dentistry, Faculty of Health Sciences, University of the Witwatersrand / The characterisation of oral and maxillofacial histopathology found in children has been reported from developed countries of the west and in some developing countries in Africa but as yet not from South Africa. A retrospective study was designed to evaluate the epidemiological features of paediatric oral and maxillofacial histopathology seen at the University of the Witwatersrand’s Division of Oral Pathology from January 1987 to December 2007. A total of 1,258 children ≤ 16 years of age with histologically confirmed disease in the oral and/or maxillofacial region were recorded, with a male to female ratio of 1:1,05. A progressive increase in the frequency of oral and maxillofacial lesions was seen with increase in the age of the patient. Most lesions were concentrated in the 13-16 year age group (41,5%). Pathology involving the jaw bones formed the largest category of all oral and maxillofacial pathologies (40% of the total number of cases) and was predominated by odontogenic cysts and tumours (61,8%). Odontogenic tumours showed a significantly higher frequency in children over 12-years of age (P=0,006). A higher frequency of unicystic ameloblastoma than in the literature was noted. The remaining pathology, in decreasing order of frequency, involved the oral and perioral soft tissues (31,6%), the salivary glands (18%), oral mucosa (8,9%) and dental hard tissues (1,7%). Most lesions of soft tissue and salivary gland were reactive / inflammatory in nature and were outweighed by fibro-epithelial polyps and extravasation mucoceles respectively. Nearly two-thirds of the oral mucosal lesions were benign Human Papilloma Virus-induced lesions. Malignant neoplasms comprised 4,1% of the total number of cases with Burkitt’s lymphoma emerging as the most common malignancy. Although the smallest number of biopsy specimens was obtained from children younger than 5-years of age, the likelihood of a malignant diagnosis in the latter age group was substantially higher than in older children.