The report evaluates the need for paediatric surgical care in an urban area of sub-Saharan Africa. Seven hundred and forty-one children were treated for surgical problems from January through December 1997. The most common surgical problems were injuries (67.1%), congenital anomalies (15.0%) and surgical infections (6.7%). Forty-six per cent of children presenting with a surgical problem required a surgical procedure, 68.2% of which were classified as minor. The annual presentation rate for all surgical conditions was 543 per 10 000 children aged 0–14 years. The estimated cumulative risk for all surgical conditions is 85.4% by age 15 years.

Our data suggest surgical diseases commonly affect children living in Banjul. Surgical care should be an essential component of child health programmes in developing countries.