OBJECTIVE: Whilst there are several published studies of the prevalence of troublesome tinnitus in childhood and adolescence (indicating that up to a sixth may experience bothersome tinnitus), there is sparse information regarding incidence. METHODS: In this study a retrospective case review of patients aged under 18 with a primary complaint of tinnitus seen in 2009 was undertaken in four European clinics known to accept such referrals. RESULTS: A total of 88 young persons with a primary complaint of tinnitus were seen in 2009 by these services, and this represents 3.8% of the paediatric clinical workload of these services and 0.3% of the total clinical workload in that year. The overwhelming majority (93%) of cases were aged 10 years or over at presentation. In only 16 cases (18%) was the tinnitus classified as severe by the reviewing clinician. Tinnitus was accompanied by hyperacusis in 34 cases (39%). CONCLUSIONS: Whilst tinnitus in childhood or adolescence can be severe, this is rarely seen in the clinic. Epidemiological data for childhood tinnitus reported previously should be interpreted with caution, as it is dissonant with the data presented in the current study. This may represent an unmet need in the population, but it may also be the case that the incidence of tinnitus in childhood and adolescence is low.