Aim: To study the sociodemographic and clinical profile of patients, who presented to the child and adolescent psychiatric services of a tertiary care centre over a 26-year period (1980-2005). Methodology: Data were abstracted retrospectively from detailed work up files of all subjects assessed in the Child and Adolescent Psychiatry (CAP) Clinic during the mentioned period. Time trends were examined over 3-periods: 1980-1989 (Period I), 1990-1999 (Period II) and 2000-2005 (Period III). Results: Most of the individuals presenting to CAP clinic were boys (62.2%-63.5%), aged between 10 to 15 years (44.2%-63.4%). The common diagnoses were mental retardation (18.4%-33.2%), neurotic and stress related disorders (16.4%-18.5%), epilepsy and organic brain disorder (7.1%-15.1 %) and hyperkinetic and conduct disorders (8.3%-17.9%). There was a trend towards decrease in number of cases in younger age group (0-5 years) and those with diagnosis of mental retardation, epilepsy and organic brain disorder. There was a trend towards increase in number of cases in the older age group (10-15 years) and those with diagnosis of psychotic disorders, affective disorders, disorders of psychological development, and hyperkinetic and conduct disorders. Conclusion: Time trends reveal significant shifts in demographic and diagnostic profile of a CAP clinic of a tertiary care hospital. (Contains 3 tables.)