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Many children with developmental problems, especially with problems in cognition or in social and emotional functioning, go to schools for special education. Whether pupils in special education have more physical limitations, handicaps and other health problems than pupils in mainstream education has not been documented recently. Therefore, child health doctors and nurses collected data regarding limitations on 2630 children in special education and on 5515 children in mainstream education, in the age-range 4-15. Results show that the prevalence of 'serious physical limitations', for example in speaking or walking, is higher in children in special education than in children in mainstream education (20.0 and 4.1%, respectively) and that the same applies for 'any physical limitation' (49.3 and 19.8%, respectively). These limitations frequently interfere with daily life and children in special education experience significantly more handicaps too. Moreover, they have other health problems more frequently, and have a higher use of health care. We conclude that the need for medical care of children in special education is great. Healthcare providers, especially in paediatrics, will have relatively many of these children among their patients but should also realise that many of these children will not seek a paediatric diagnosis and treatment. The studies as described have been performed some years ago. It can be expected that the health problems among pupils in special educations have increased since then, because current policies aim at the integration of children with developmental problems in mainstream education. Therefore, morbidity is likely to increase among those remaining in special education, but paradoxically also in mainstream education.