This study is an assessment of the school heal t h service in Addis Ababa which has been operating for the last 45 years. Fifty-seven school clinics serving a student population of 197,181 were se l ected according to set criteria . 'rhese school clinics were visited, medi cal records and reports for the 1985/86 school year revie\'19d , and school health workers interviewed. Najar he alth problems of school childr"n and problems in th ... delivery of the school h~alth servi ce its ~lf are i dentified . Accidents and injuries were .round to be the most prevalert health problems of school childrf;n \vith .:in overall incidence rate of about 22%. Over 45% of the: report ed deaths fer W1lich causes were possibly kno\vn during ·the same period were also aue t o accidents . Other categories of health problems includ.~ inte stinal parasite, dental problems, skin infections, eye and Ear probl ems and venereal diseases .. Available data s ugge !3t that most of these problems were cons istantl y o':;curring over the past 26 yeurs, E~X Cl2:pt for dental caries which has possibly appedred as .1 new phenomena in recent years. Comparison of the morbidity patterns between the school population and the general population of Addis 1lbaba did not show major differences . On the whole 1 most of the dis eas~ s and conditions idantified are o f the typc that can be prevent"d through general public health m€i1c.ures . Nost of the school clinics havL~ seri ous probl (:::l-:IS of space, budget 7 drugs and ffillnpower:_u Over T:::'r of the school clinics surveyed have only onc room each and about £:5% W'2re staffed by on0 hedlth worker each. Lack o f provision [or refresher courSGS r i nadequatt. supervisi on and ambulance problenls we r e a lso r eported. School }j;!alth s e r vice activiti es were found to be incomple t e in most of the important 3ctivities like pariodic medical examination of children, screening f o r defects and vaccinations . From the f i ndings of this study it can safely be concluded 'that school health servi ce i s a n.Ajlected <&rea of service demanding urgent acti on and therefore I' some recoTrUllendatiuns a:re made to help ill improving the exi sting s ituation