The incidence of burns in developing countries is not precisely known due to unavailability or incompleteness of death registration and disease reporting. In this study, we determined prevalence and age-specific incidence of burns in children 0-5 years in the Ashanti region of Ghana using burn scars as proxy. We used a community-based, multi-site survey to identify children who had scars as evidence of previous burns. A scar prevalence of 6 per cent was found. No sex differences were found. However, significant differences were found among age groups, with children aged 18-23 months having the highest incidence (57.4 per 1000 person-years). There was evidence of focal occurrence of childhood burns in certain districts, and a higher prevalence in rural areas. We conclude that childhood burns are a significant health problem in Ghana, especially among rural residents and the very young, and recommend that interventions be developed to control them.