Lung abscess continues to be a significant problem in childhood. Eighty-three cases of this condition have been reviewed. From the available data these have been found to fall into two groups which have been classified as primary and secondary. Consideration of the aetiology has revealed that the commonly quoted predisposing features, namely tonsillectomy and foreign body aspiration, are no longer of such paramount importance. The causative organism is a staphylococcus in the majority of cases. This is at variance with other published findings. The more general use of antibiotics in all respiratory diseases is responsible for some of the changing patterns noted. The management of lung abscess in childhood also presents a changing picture. Bronchoscopy is being supplanted by more conservative measures.