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Abstract: Aim: A Belgian registry for pediatric Crohn's disease, BELCRO, was created. This first report aims at describing disease presentation and phenotype and determining associations between variables at diagnosis and registration in the database. Methods: Through a collaborative network, children with previously established Crohn's disease and newly diagnosed children and adolescents (under 18y of age) were recruited over a 2year period. Data were collected by 23 centers and entered in a database. Statistical association tests analyzed relationships between variables of interest at diagnosis. Results: Two hundred fifty-five patients were included. Median age at diagnosis was 12.5y (range: 1.6–18y); median duration of symptoms prior to diagnosis was 3m (range: 1–12m). Neonatal history and previous medical history did not influence disease onset nor disease behavior. Fifty three % of these patients presented with a BMI z-score<−1. CRP was an independent predictor of disease severity. Steroids were widely used as initial treatment in moderate to severe and extensive disease. Over time, immunomodulators and biological were prescribed more frequently, reflecting a lower prescription rate for steroids and 5-ASA. A positive family history was the sole significant determinant for earlier use of immunosuppression. Conclusion: In Belgium, the median age of children presenting with Crohn's disease is 12.5y. Faltering growth, extensive disease and upper GI involvement are frequent. CRP is an independent predictive factor of disease activity. A positive family history appears to be the main determinant for initial treatment choice. [Copyright &y& Elsevier]