Peptic ulcer disease (PUD) has been reported to occur in children worldwide, but no information is available for our community. The aim of the study was to report our experience on the pattern of this condition in Saudi Arabian children. The records of all children below 18 years of age who were diagnosed by endoscopy to have PUD over a period of 10 years were analysed. From 1993 to 2002, 24 children out of 521(5 per cent) who presented with upper gastrointestinal tract (GIT) symptoms were diagnosed by endoscopy to have PUD. All but one (96 per cent) were Saudi nationals, the average age was 15 years (range 5-18 years), and the male to female ratio was 7:1. The commonest presentation was chronic abdominal pain in 15/24 (63 per cent) of the children, followed by vomiting associated with abdominal pain in four (17 per cent). Hematemesis and melena occurred in three (13 per cent), and two children (8 per cent), respectively. There were 20 duodenal (92 per cent) and four gastric ulcers. The primary type was the most common, occurring in 19 (79 per cent) of the children. Histopathology results of antral biopsies were available for 15 children; all of them had antral gastritis. Helicobacter pylori organisms were present in 13/15 (87 per cent) of the antral biopsy specimens. In Saudi children, peptic ulcer disease occurs more commonly in boys. It is a rare cause of upper GIT symptoms, but highly associated with H. pylori antral gastritis. This study documents a pattern similar to descriptions from other countries.