In order to arrive at population-based estimates on the prevalence and characteristics of children and adolescents with specific health care needs (CSHCN), screening instruments focussing on the consequences of physical, mental and behavioral problems rather than on medical diagnoses have been developed. One of the most feasible and widely tested instruments, the CSHCN screener was added to the self-administered questionnaire for parents of children participating in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). The overall weighted prevalence of CSHCN was 16.0% among boys and 11.4% among girls. Children at kindergarten or school age were more than 2-3 times more likely to screen positive compared to toddlers. Up to 14 years, the sex difference persisted through all age groups and was most pronounced between the ages of 3 and 10 years. Children with a migrant background had significantly lower rates of CSHCN compared to non-migrants. This was particularly true for boys (8.0% vs. 17.1%). CSHCN status was not related to social status, urbanization or residence in former West vs. former East Germany. Except for the lack of association with social status, these results are in good accordance with observations from the US National Survey of CSHCN.