Most medicines have not been evaluated for use in children and are widely used off-label in this patient population. Data supporting medicine use in children stem from various sources of heterogeneous quality. There exist no representative data on medicine use in children in Austria. The aim of this survey was to identify all medicines used in children and adolescents in Austria, to evaluate their extent of off-label use, and to define a list of around 200 medicines most frequently used in this patient population. Reimbursement data of medicines prescribed to children and adolescents were collected from Austrian health insurances and data of medicines dispensed to paediatric wards were collected from hospital pharmacies. By this, we derived prescription frequencies for both, paediatric primary and hospital care settings. We analysed these data by Anatomical Therapeutic Chemical (ATC) classification system, patients age (only primary care setting), region of prescription (Vienna versus rest of Austria) and type of hospital care setting (secondary versus tertiary care). As anti-bacterials for systemic use turned out to be most frequently prescribed in both, primary and secondary care setting, we analysed this class of medicines by its subgroups, patients age, type of hospital care setting and region of prescription. Furthermore, we evaluated the extent of off-label medicine use in children and adolescents and obtained qualitative information on prescription patterns by performing interviews with physicians in paediatric general primary care and psychiatric care. We could find out that in primary care setting anti-infectives (mainly antibiotics for systemic use), medicines for the respiratory system (medicines for obstructive airway diseases, nasal preparations, cough and cold preparations, anti-histamins for systemic use) and nervous system (analgesics, antiepileptics, psychostimulants) were most frequently prescribed. In hospitals, highest prescription frequencies occurred for anti-infectives (mainly systemic antibiotics), medicines for the nervous system (analgesics, anaesthetics) and alimentary tract (various groups, mainly antacids, anti-emetics). Off-label use is decreasing with age from 52% to 11% of all prescriptions in primary care setting, and from 54% to 18% in hospital setting. Primary care paediatricians prescribe medicines for a panel of about 20 to 30 diagnoses. Depending on the diagnosis, prescription habits considerably vary among the physicians. Most heterogeneous prescriptions occur for common infections like cough, non bacterial otitis or rhinitis. The results of this survey provide important epidemiological information specific for Austria and also serves as basis for a future project to develop an on-line information platform for medicines used in children and adolescents.