Fifty-six patients with a pathological lesion at the leadpoint of their intussusception were encountered at the Royal Children's Hospital, Melbourne, over a 16-year period. The most common lesions were Meckel's diverticula, followed by small bowel polyps, lymphosarcomas, and duplication cysts. Age at presentation was the only factor discriminating these patients from patients with idiopathic intussusception. Unlike previous studies, duration of symptoms was not useful in identifying a pathological leadpoint. Hydrostatic reduction was successful in reducing the leadpoint in three of 21 attempts. Neither morbidity nor mortality was encountered in a policy of initial enema reduction of intussusception, regardless of age.