A survey of all notified cases of tuberculosis in England and Wales in children (less than 15 years old) in 1988 was undertaken to study changes in the frequency and distribution of disease in the population since similar surveys in 1978-9 and 1983. There were 294 children with newly notified previously untreated tuberculosis, an annual rate of 3·1/100 000. Children of Indian, Pakistani, and Bangladeshi (Indian subcontinent) ethnic origin formed the largest group (134 (46%)) but only 29 (22%) of these children were born outside the UK. The rate for children of Indian subcontinent ethnic origin born abroad (53/100 000) was twice that for those born in the UK (26/100000), but the latter was 17 times higher than the rate for white children (1· 5/100 000). These ratios have changed little since the first survey in 1978-9 and highlight the need for improvement in the prevention and control of tuberculosis in children known to be at increased risk.