PURPOSE: This study was done to describe utilization status of emergency medical service for children at one university affiliated hospital located in Seoul. Data were obtained from the medical records of patients under 13 years of age who visited the ER from January 1 to December 31, 2006. METHOD: Medical records missing the time of discharge were excluded in the analysis of waiting time, which resulted in 19,766 cases. Data were analyzed using SPSS WIN 14.0 version. RESULT: There were slightly more boys (58.4%), average age of the children was 3.97 years of age. More children at the aged 1 to 3 years (51.3%) visited the ER. Fever was the most frequent complaint: 5,180 cases (24.38%). The other complaints were head or facial laceration (10.55%), vomiting (9.63%), abdominal pain (8.06%), cough (7.67%), and painful limb swelling (6.34%). Average waiting time before the first medical examination was 17 minutes, and average ER stay time was 3 hours and 23 minutes. CONCLUSION: The results suggest the need to assign a nurse specialist for pediatric ER to provide more efficient care for the children. Also, extra staff assignment during the evening shift or extending office hours of local pediatricians should be considered.