Although chloral hydrate sedation has been recommended as an alternative to general anesthesia for pediatric examinations, we have had inconsistent effects after rectal applications for ophthalmologic examinations. A retrospective analysis of rectal chloral hydrate for computer-assisted tomographic (CT) examinations on 20 pediatric patients revealed that after a single application, sedation was sufficient in only 4 cases. In 14 cases, additional doses and/or drugs were required. Altogether, 6 examinations were canceled because of insufficient sedation. Therefore, the safety and effectiveness of oral chloral hydrate (60-100 mg/kg) was studied prospectively in 32 pediatric ophthalmologic examinations of 20 patients. The unpalatable taste of chloral hydrate may result in inconsistent intake, but all intended examinations and manipulations could be carried out with only minimal side effects. Oral chloral hydrate seems to be safe and effective for painless pediatric examinations and may be more reliable than rectal chloral hydrate.