A randomised controlled trial was undertaken to compare the safety and appropriateness of pre-operative assessment of children prior to day case or minor surgery between five nurses and six senior house officers (SHOs). The nurses received 30 hours of training in history taking and physical assessment. Sixty children were randomly allocated to be assessed by an SHO or an assessment trained nurse and then by an expert (a specialist registrar paediatric anaesthetist). All children with no detectable abnormalities were identified correctly by both groups. The nursing group identified 85 per cent of the detectable abnormalities with the SHO group identifying 47 per cent. Parents, nurses, SHOs and surgeons were supportive of the initiative but anaesthetists were not so positive in their views. A larger study would indicate whether nurse-led pre-operative assessment could help to optimise pre-operative care of children.