Previous studies have documented a variation in the occurrence of musculo-skeletal conditions affecting the hip and foot in the New Zealand Maori and Pacific Island races compared with the European race in New Zealand. Similar data regarding scoliosis are lacking. A manual and computerised review of outpatient records of Starship Hospital (1989–2000) and Middlemore Hospital (1997–2000) revealed 363 patients less than 20 years of age with a diagnosis of scoliosis. Major aetiological diagnoses included adolescent idiopathic (63), syringomyelia (12), myelomeningocele (16), cerebral palsy (55) and congenital (55). Significant racial variations were noted in the idiopathic, syringomyelia and neuro-muscular groups compared with New Zealand census predictions. Idiopathic scoliosis was uncommon in Maori (9%) and rare in Pacific Islanders (1%). Conversely, these groups accounted for 66% of all scolioses and over 50% of Maori and Pacific Islanders were found to have a syrinx. MRI is indicated in Maori and Pacific Islanders with apparent adolescent idiopathic scoliosis. Maori accounted for 31% of patients with myelomeningocele and scoliosis. 40% of patients with cerebral palsy and scoliosis were Maori, reflecting the known inferior status of perinatal and other health parameters in this group of people.