Thirty-two Saudi children (aged 1.5-14 years) with goitre were seen over a 6.5-year period in a paediatric endocrinology clinic. There was a female to male ratio of 1.9:1. Of these, 27 (84.3%) had diffuse thyroid enlargement and five (15.7%) nodular goitre. The commonest causes were dyshormonogenesis (37.5%) followed by Hashimoto's thyroiditis (34.4%). Three boys and one girl had Graves' disease. There were three (9.4%) with simple goitre and one case each of iodine deficiency goitre and tuberculous thyroiditis. Further study of the prevalence and causes of goitre, including iodine deficiency goitre, in Saudi Arabia is suggested.