OBJECTIVE--To estimate the prevalence of bullying in primary school children and to examine its association with common symptoms in childhood. DESIGN--Semistructured health interview conducted by school nurses as part of a school medical. SETTING--Newham, east London. SUBJECTS--All children in year 4 of school during the academic year 1992-93. MAIN OUTCOME MEASURES--Reported bullying and common health symptoms. RESULTS--2962 children (93.1% of those on the school roll) were interviewed (ages 7.6 to 10.0 years). Information about bullying was not recorded for 114 children, 22.4% (95% confidence interval 20.9 to 24.0) of children for whom information was available reported that they had been bullied. There was an association between children reporting being bullied sometimes or more often and reporting not sleeping well (odds ratio 3.6, 2.5 to 5.2), bed wetting (1.7, 1.3 to 2.4), feeling sad (3.6, 1.9 to 6.8), and experiencing more than occasional headaches (2.4, 1.8 to 3.4) and tummy aches (2.4, 1.8 to 3.3). A significant trend for increasing risk of symptoms with increased frequency of bullying was shown for all reported health symptoms (P < 0.001). CONCLUSIONS--Health professionals seeing primary schoolchildren who present with headaches, tummy ache, feeling sad or very sad, bed wetting, and sleeping difficulties should consider bullying as a possible contributory factor.