problematic sickness absence with 10% missing more than nine days and 14% reported sick more than four times.Of all the pupils, 28 % had at least one doctors' visit (0-35 times), 28% had other excused absence (0-56 times), 11% were late at least once (0-80 times) and 4% had unexcused absence at least once (0-14 times). Conclusions:Sickness absence is the most prevalent type of school absence.Sickness absence is also extensive in the Netherlands: one in six pupils had problematic sickness absence and one in ten pupils missed more than two school weeks in a school year, which equals five per cent of the school year.Problematic sickness absence can have a negative impact on the pupils' development and (future) health.While the schools support these children in their educational and social development, it should be a public health task to address the underlying cause of sickness absence and prevent the negative consequences.