Because play is extremely sensitive to environmental conditions, extended hospitalization may have adverse effects on normal play development in young children. This study compared the playfulness, as well as the level of play development, of three 2-year-old children who had been hospitalized most of their lives for tracheostomies, and three 2-year-olds living at home. Data on the children's play were gathered by videotaping in two standardized play settings and one free play setting. Statistically significant differences in the developmental level of play and in playfulness (i.e., the degree of liveliness and joy exhibited) were found between the two groups in all three settings, and the play age of all six children varied by setting. Quantitative data analysis was supported by qualitative findings. Although the differences between the groups cannot be conclusively attributed to hospitalization alone, certain features of the hospital environment appear to have hampered the development of play.