In this paper, we investigate the intrinsic spin‐Hall effect in mesoscopic systems, i.e. spin‐orbit induced spin‐polarizations with and without external magnetic fields in confined two‐dimensional systems at low temperatures. We employ a non‐equilibrium Green's function approach that takes into account the coupling of non‐equilibrium spin occupancies and spin‐resolved electronic scattering states in open nanometer quantum systems. Importantly, our calculations go beyond the widely used continuum approximation of the spin‐orbit interaction in the envelope function approximation and are based on a microscopic relativistic tight‐binding approach that ensures the spin‐orbit effects to be properly taken into account for any degree of charge confinement and localization and to all orders in the electron wave vector. We show that the qualitative trends and results in spin polarizations, their dependency on charge density, spin‐orbit interaction strength, and confinement, as obtained within the envelope function approximation, agree with the results of atomistic calculations. The quantitative results, on the other hand, can differ significantly. (© 2008 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)