The objective of our study was to evaluate the appropriateness of admission and hospital stay in pediatric wards of a Teaching Hospital in Rome using the Italian version of pediatric Appropriateness Evaluation Protocol (AEP). We reviewed 263 medical records of patients admitted in hospital during 2004. For each hospitalisation a judge on appropriateness/inappropriateness of admission and hospital stay was elaborated. We retrieved also data on type of ward, date, time and type of admission, date of discharge and data related to each patient. We carried out an univariate and a multivariate logistic regression analysis. Our results showed that the risk of an inappropriate admission is associated to residence out of Rome (OR = 2.45; CI 95%: 1.35-4.47) while the urgent admission is protective against inappropriateness (OR = 0.14; CI 95%: 0.07-0.25). The inappropriate hospital stay is associated to inappropriate admission (OR = 5.82; CI 95%: 3.17-10.70) and hospitalisation in a medical ward (OR = 3.26; CI 95%: 1.81-5.90). Stay in hospital in spring or summer periods is protective against hospitalisation inappropriateness (OR = 0.52; CI 95%: 0.30-0.91). The percentage of inappropriate admission and hospital stay is, respectively, 42.1%, and 50.2%, thus pointing out that there is the need of organisational interventions to reduce inappropriate hospitalisations.