To examine whether motor vehicle exhaust from freeways has an effect on respiratory health of children, a cross-sectional study was conducted. Children attending schools situated less than 1000 m from major freeways in the Province of South Holland were asked to participate. The selected freeways carry between 80,000 and 150,000 vehicles per day. Separate counts for truck traffic indicated a range from 8000 to 17,500 trucks per day. At a total of 13 schools, 1498 children were asked to participate. From these children, 1068 usable questionnaires were obtained. Chronic respiratory symptoms reported in the questionnaire were analyzed with logistic regression. Distance from the freeway and (truck) traffic intensity were used as exposure variables. Cough, wheeze, runny nose, and doctor-diagnosed asthma were significantly more often reported for children living within 100 m from the freeway. Truck traffic intensity and the concentration of black smoke measured in schools were found to be significantly associated with chronic respiratory symptoms. These relationships were more pronounced in girls than in boys.