Aim Children in statutory out‐of‐home care (OOHC) are known to have poorer physical, developmental and mental health outcomes compared with their peers. The number of children in OOHC is increasing in Australia, with Aboriginal and Torres Strait Islander children disproportionately represented. To document the health needs of Aboriginal and Torres Strait Islander children and adolescents in OOHC attending the paediatric service at the Victorian Aboriginal Health Service (VAHS) between February 2014 and February 2016. Methods The electronic medical records of all patients in OOHC seen by a paediatrician at VAHS between February 2014 and February 2016 were audited. Demographic data, including age and type of OOHC placement, were recorded, as were their health needs. Results Of the 200 children seen by a paediatrician over this 2‐year period, 103 were identified as being in OOHC for all or some of this same period: 43 in foster care, 8 in residential care and 52 in kinship care. Of the 103 children, 35 were <6 years of age, 51 between 6 and 13 years and 17 between 13 and 18 years; 66% were identified as having mental health problems, 37% hearing problems, 34% vision problems, 40% dental caries and 46% developmental delay including 36% with speech delay. Conclusions Aboriginal and Torres Strait Islander children in OOHC seen by the paediatric service at VAHS have high rates of physical, developmental and psychological health needs. These data have significant potential to inform government policy and investment in effective models of care to better meet the needs of Aboriginal and Torres Strait Islander children in OOHC.