AIM: To determine population-based prevalence, hospital use and costs for children admitted to hospital with chronic conditions. METHODS: We used hospital admissions data for children aged <16 years, 2002-2013 in New South Wales, Australia. RESULTS: Of all admissions, 35% (n = 692 514) included a diagnosis of a chronic condition. In 2013, prevalence was 25.1 per 1000 children. Children with greater socio-economic disadvantage or living in regional and remote areas had lower prevalence, but a higher proportion of emergency admissions. Prevalence rates were highest for respiratory and neurological conditions (9.4, 7.4 per 1000, respectively). Mental health conditions were most common in older children. Admissions involving chronic conditions had longer length of stay (3.0 vs. 1.6 days), consumed more bed-days (50% of total) and involved 43% of total hospital costs. CONCLUSION: Differences in prevalence and use of hospital services suggest inequities in access and need for more appropriate and equitable models of care.