Aims: The aims of this study were to investigate the extent of documentation of anthropometric measurements in a children's hospital records, the response of ward staff to children with heights and weights below the 3rd centile, and the availability and accuracy of measuring equipment. Also to assess the nutritional knowledge of medical staff. Methods: A prospective study was carried out in which 305 medical case notes were reviewed for records of anthropometric measures and action taken. A survey was undertaken of the availability of anthropometric equipment and its accuracy assessed over a range of weights and heights. A sample of medical staff (n=25) were interviewed about clinical nutrition. Results: Eighty-three per cent of the nursing notes and 13% of the medical notes contained records of weights, and 12% of the nursing notes and 8% of the medical notes contained records of heights. Only 40% of case notes had growth charts present, of which 54% had weights recorded and 32% had heights recorded. Surgical ward notes more frequently had inadequate records of weights, heights and growth charts than those of medical wards (surgical wards had 17% growth charts present compared to 65% growth charts on the medical wards). Overall, most wards and clinics had working and accurate weighing equipment (82% were accurate within 1%) and height equipment (43% were 100% accurate). Over 80% of ward staff appeared to have adequate knowledge of the theory behind anthropometry and recognized the value of growth charts. Conclusions: The weights and heights of children continue to be recorded inadequately in hospital notes, suggesting a need for in-service training and education on the importance of the nutritional assessment of paediatric patients.