We retrospectively reviewed the results of 42 cardiopulmonary arrests occurring over 1 yr in the general ward of a pediatric hospital. These data were compared to those of a similar study done 10 yr previously in the same institution. Patients were divided into those having pure respiratory arrest and those who also had cardiac arrest. In the most recent series, overall 6-month survival was 17%; however, only 9% of the cardiac arrest patients survived. Ten years previously, the survival rate from cardiac arrest was 11%. In both series, pure respiratory arrest had a significantly better outcome than cardiopulmonary arrest, and predictors of nonsurvival were a duration of arrest greater than 15 min and the administration of more than one iv bolus of epinephrine. During the more recent series, sepsis and upper airway problems produced fewer arrests. There was one neurologically damaged survivor in each study period. Our study confirms that the outcome of pediatric cardiac arrest is poor when arrest occurs in the hospital.