Objectives: The aim of this study was to estimate the influenza vaccine coverage among children attending paediatric ER. Methods: The parents of patients attending paediatric ER during the winter of 2003-2004 were inquired about their children's influenza vaccination status, whether the vaccine was recommended by the primary paediatrician recommendation, the medical history, and about several epidemiological details. Results: Total of 557 questionnaires were completed. Mean age was 5.8 years. Only 23 of the 557 patients were vaccinated (4.1% coverage). Vaccine coverage in the 107 children from high risk groups was 6.5% and vaccination rate in the 144 infants aged 6-24 months was 2.7%. Influenza vaccine was recommended by the primary paediatricians in 59 cases (10.6%). Vaccine was recommended to 22.4% of patients from high risk groups, to 7.6% of infants aged 6-24 months of age and to 7.8% of the other children. Conclusions: Influenza vaccine coverage among Israeli children is low, including patients from high-risk groups, and awareness of the primary paediatricians seems to be unsatisfactory.