Introduction: Recurrent abdominal pain is frequent in paediatrics. Dyspepsia is one of its clinical forms. The purpose of this study was to characterise dyspepsia in children; particularly to define its clinical presentation, the upper inflammatory conditions found in association with it and to evaluate the evolution of symptoms after current therapeutic modalities. Methods: The information regarding 297 children beyond 6 years of age was included. They had been referred by their paediatrician during a period of 27 months due to recurrent abdominal pain or a diagnosis of acid peptic disease. In the gastroenterology clinic the impression was that dyspepsia (as defined by the Rome II criteria) was the predominant feature. Results: Fifty four percent were girls. Mean age was 11 (6–17) years. Duration of symptoms was 7 (1–48) months. The most frequent symptoms were epigastric pain and nausea. Fifteen percent were classified as ulcer-type and 6.7% as dismotility-type dyspepsia. Gastro-oesophageal reflux and irritable bowel were associated in 38 and 33% respectively. Endoscopy was performed in 119 (40%): only one duodenal ulcer was found (0.8%); near two thirds had mild inflammation o normal endoscopic findings. Helicobacter pylori was found in 63 (53%); fourteen children (22%) had eradication therapy. Drugs (variably used) induced remission of symptoms in 80–88%, similar to that observed in children who had no prescription (21%). No difference was found between the children who had anti-H. pylori treatment and those who did not. Conclusion: A description of paediatric dyspepsia is provided. Clinical information and selection of patients allow therapy to be kept simple and less expensive. Dyspeptic children usually do not suffer significant organic disease and improve relatively easy.