For both genetic and environmental reasons the prevalences and characteristics of the rheumatic diseases affecting North American Indian children might be expected to differ from those of similarly affected non-Indian children. We reviewed 34 Western Canadian Indian children with rheumatic disorders. For comparison a group of Caucasian children with chronic arthritis was also evaluated. The prevalence of clinic attendance by Indian children (.059%) was substantially but not significantly more common than attendance by non-Indian children (.034%). When compared to the seronegative spondyloarthropathies (SSA), juvenile rheumatoid arthritis (JRA) was relatively less common in the Indian population (1.2:1) than in the Caucasian children (5.4:1). Of the children with JRA, polyarticular onset type, positive tests for rheumatoid factor and HLA-AW24 were significantly more common in the Indian population (p less than .05). The characteristics of Indian and of non-Indian children with SSA did not differ significantly. Even though an increased prevalence of HLA-B27 may account for the relative increase of SSA in the Indian population, this study indicates that childhood rheumatic diseases other than B27 associated SSA should be recognized as occurring frequently in Indian children.