Aim: To provide knowledge of drug prescription patterns in general and of antibiotics in particular, and number of consultations and diagnoses leading to prescriptions among children aged 0-4 y in the Arctic. Methods: A population-based cohort of children aged 0-4 y, living in Sisimiut, the second largest town in Greenland, was followed from August 1996 to December 1998. Information on consultations, diagnoses and drug prescriptions was obtained from medical files at the local health centre. Results: Among 280 participating children, the mean number of consultations per child was 5.64 per year at risk (range 0-17), of prescriptions 4.02 per year at risk (range 0-17.2), and of prescribed systemic antibiotics per child 1.47 per year at risk (range 0-7.25). Systemic antibiotics formed the therapeutic subgroup most often issued for children, constituting 33.5% of all prescriptions. Of the systemic antibiotics, 50% were broad-spectrum penicillins, 34% penicillin V, 14% macrolides and 2% other antibiotics. The most frequent diagnoses leading to drug prescription in general as well as to prescription of systemic antibiotics were respiratory tract infections, accounting for 59% of all prescriptions and 81% of prescriptions of systemic antibiotics. Children aged 1/2-1 y of age had the highest prescription rates of drugs in general and of systemic antibiotics. Conclusions: Compared to other countries, prescription rates of drugs in general and of systemic antibiotics in particular were high. The use of broad-spectrum penicillins was higher than recommended in Greenlandic national guidelines, and might be reduced.