Objective: To explore the actual prevalence of vocal nodules among school age children. Methods: A total of 617 children aged from 7 to 16 years were examined. Their voices were recorded and analyzed by using acoustic analysis techniques, and vocal folds were examined by using rigid telescopic laryngoscope. The findings were noted as normal, minimal lesion, immature and mature nodules. Results: Laryngoscopic examination revealed that 430 (69.7%) of the children were normal. Of the remaining 187 children, 82 (13.3%) had minimal Lesion, 88 (14.3%) immature nodule, 16 (2.6%) mature nodule and 1 (0.2%) vocal polyp. Comparisons of acoustic parameters revealed that there were no statistically significant differences between normal and minimal lesion groups, and between immature and mature nodule groups. Actual vocal nodule ratios which include both immature and mature nodule groups among whole school children were found to be 21.6% in mates and 11.7% in females. (C) 2003 Elsevier Ireland Ltd. All rights reserved.