Objective.-To determine if the policy recommendations of the American Academy of Pediatrics (AAP) regarding television viewing are heeded in an inpatient pediatric setting. Setting.-An inner-city academic medical center. Participants-Consecutive sample of 199 pediatric inpatients. Methods.-An investigator visited all pediatric inpatient rooms. Observations were made when the patient was present in the room, alert, and awake. The main outcome measure was exposure to inappropriate programming. In accordance with AAP guidelines, we used the established television rating system to code programs as appropriate versus inappropriate for children. We classified G- and PG-rated shows that centered on adult themes or that were not informational, educational, and nonviolent as inappropriate. We tested parental demographics, age of child, time of day, and presence of an adult in the room as possible predictors. Results.-Ninety-one percent of the patients had the television turned on. Of these, 53% were tuned to inappropriate programming. Exposure to inappropriate programming did not differ by parental ethnicity, language, or education. Exposure was, highest for infants and toddlers as compared with children or adolescents (74% vs 40% vs 52%, P = .001); it did not vary by time of day. Exposure was higher when an adult was present in the room (58% vs 42%, P = .05); this effect was most pronounced for adolescents (68% vs 41%, P = .05). Conclusions.-Despite AAP recommendations, hospitalized children are exposed to inappropriate programming, especially when parents are present in the room. Hospital stays may be a unique opportunity to educate parents about the AAP recommendations for television viewing by children.