A chart review was conducted of the records of 90 children and 90 adults, randomly selected and matched for sex and diagnosis, to investigate analgesic usage. Four diagnostic categories (hernias, appendectomies, burns, and fractured femurs) at two hospitals were examined. Results revealed that adults received an average of 2.2 doses of narcotics per day, whereas children received 1.1 (P = .0001). Significant differences in dosing were noted between the diagnostic categories. Diagnoses associated with a longer hospital stay showed a greater discrepancy between narcotic usage in children and adults. Hospital differences were also significant (P = .004) with more doses per day administered at the urban hospital than the rural one. Infants and young children were less likely than older children to have narcotics ordered for them, but, if ordered, frequency of administration was similar for all children. Our study demonstrates that children and adults with the same diagnoses are treated differently as regards narcotic administration. Further research is necessary to determine whether these results represent a difference in pain tolerance in children or a lack of recognition of their discomfort.