SETTING Understanding tuberculosis (TB) epidemiology among children is critical to overall TB control. OBJECTIVE To investigate the trends and epidemiological and clinical characteristics of TB in children aged 0-14 years in Taipei City, Taiwan. DESIGN Data on all childhood TB cases in Taipei City from 1998 to 2005 were obtained from the National Tuberculosis Registry Database. RESULTS TB incidence rates increased significantly in both adults and children aged 0-14 years during the study period. The age-specific rate in children was highest in 10-14-year-olds and lowest in the 5-9 years age group. Of the 163 childhood TB cases, 52 cases (31.9%) were extra-pulmonary, with the highest proportional rate, of 39.6%, in the 0- 4 years age group. The most common site of extra-pulmonary involvement was the lymph nodes, followed by the bones and joints and the pleura. Bone and joint involvement occurred significantly more often in children aged 0- 4 years, while pleural disease was significantly more frequent in children aged 10-14 years. Only two cases of TB meningitis were identified. CONCLUSIONS The increase in childhood TB may be associated with the increase in the incidence of the disease in adults. Identifying and treating infectious sources, usually adults, can reduce the risk of TB exposure in children.