OBJECTIVE: To determine the incidence of insulin-dependent diabetes mellitus in 0- to 14-year-old children in Shanghai, China, from 1980 to 1991. RESEARCH DESIGN AND METHODS: Data were collected from hospitals with pediatric departments. The secondary source of validation was primary and middle schools. RESULTS: The average crude annual incidence rate was 0.61/100,000 (95% confidence interval, 0.48–0.77). The ascertainment-corrected incidence rates were 0.72/100,000 (0.57–0.91). CONCLUSIONS: The incidence of childhood diabetes in Shanghai, China, was one of the lowest, if not the lowest, in the world.