Despite the widespread view that children have difficulty swallowing pills, data are limited. In an observational cohort study, pill swallowing ability (small oral tablet) was assessed in children age 6 to 11 years. A total of 113 of 124 subjects (91%) swallowed a tablet using an ordinary cup or a patented pill cup. All 57 subjects who initially said they could swallow a pill were capable. Forty-seven learned with an ordinary cup and nine with the pill cup. Eleven did not learn. The majority of children (91%) age 6 to 11 years were able to successfully swallow a small oral tablet.