Objective: To assess the demographic and time trends in hospitalisation rate for Pulp and Periapical Diseases (P&PDs) over 20-years (1998-99 to 2017-18), amongst children and adolescents (under age 19 years) in all states and territories of Australia. P&PDs are considered potentially preventable, with the possibility of them resulting in emergency presentations if timely treatment is not provided. They can result in treatment under general anaesthesia, which is costly. Design: Retrospective analysis of hospitalisation for pulp and periapical diseases. Setting: Public and private hospitals across Australia. Main outcome measures: The number of hospitalisations (measured using the number of separations or cases of hospital admission) for all pulp and periapical diseases by age-group. Results: There were about 40,000 hospitalisations regarding P&PDs over the 20 years among Australian children under 19 years old. The rate of admissions ranged from means of 28.5 to 44.1 per 100,000 population. The number of admissions increased over 20 years for all children, except those younger than 4 years. Children aged 5-9 years had the highest rate of admissions and, more days in hospital per admission than other age groups. Most children only had one-day admissions. Conclusion: Pulp and periapical diseases hospitalisation rates have increased over two decades. Additional approaches to improve child dental health in Australia need to be considered. Keywords: Children, Australia, hospitalisation, dental pulp diseases, periapical diseases