Objectives To explore whether admissions to a child mental health inpatient unit in a tertiary care paediatric hospital were justified and estimate whether inpatient unit provided a beneficial service to patients and their families.Method A retrospective analysis of 191 consecutive admissions to unit over 15 months. Relevant information was obtained from clinical case notes recorded and maintained during hospital stay. Additional data was obtained from standardized assessment schedules used for validation of diagnoses and neuropsychological assessment carried out during admission.Results Ages ranged from 2-12 years. Most patients were referred by paediatricians. Medically unexplained somatic symptoms and disruptive behaviour were the most prevalent presenting features. Multidisciplinary approach to care and objectively supported assessment and intervention strategies were beneficial in over 80% of patients. Average duration of hospitalisation was 6.4 days. None dropped out of treatment. There was a 12% readmission rate and an 18.4% unsatisfactory rating for outcome.