The authors assessed the event detection rate and clinical usefulness of short duration, outpatient video electroencephalographic monitoring (VEM), in the pediatric age group. The duration of monitoring was set at a two-hour period. One hundred consecutive patients aged 0-18 years were enrolled in the study. Patients belonged to one of the following groups: A) patients evaluated to differentiate between true epileptic seizures and nonepileptic events; B) patients with known epilepsy evaluated for a better definition of their seizure type; C) patients with isolated EEG abnormalities evaluated to identify unrecognised, subtle seizures. An additional group D, included patients with enhancement of spike activity induced by sleep. Eighty- seven patients experienced at least one event per week and 13% had less than one event weekly. The event detection rate was 53% overall, and 61% in the first group of 87 patients. In patients who had events recorded and characterized, epileptic seizures were identified in 37 children (69.8%), and non-epileptic events in 19 children (35.8%). Diagnostic yield was especially high in children with mental retardation who had predominantly non-epileptic events. VEM was judged successful and/or informative in 73 cases (73%), and turned out to be useful even in patients with a low baseline frequency of clinical events.