Introduction: Paediatric population still represents a high burden of hospitalisations among burns inpatients. Children under five years old have a distinct aetiology distribution comparing to other age groups, representing in Portugal a fifth of all hospitalisations with burns. We aimed to describe the demographic and clinical burden of burns requiring hospitalization, as well as hospitalization charges, among this age group in Portugal. Methods: We performed a retrospective study including inpatients younger than five years-old and discharged between 2011 and 2015 in a public Portuguese hospital with a main or secondary diagnosis of burns (ICD-9-CM: 940.xx-949.xx). Clinical and demographics characteristics were assessed, as well as hospital reimbursement charges. Results: A total of 1217 hospitalisations with burns were found, with a hospitalization rate of 54.6 hospitalisations/100,000 inhabitants/year, higher among boys. Ninety percent of them were due to hot liquid or objects. There were three in-hospital deaths. There was a median length of stay of 9 days and a mean hospitalization reimbursed charge of 3073 Euros (4918 I$). Non-rural: rural hospitalization rate ratio was of 0.42:1. Évora and Bragança were the districts with higher hospitalization rate with 116 and 107, respectively. Discussion: This Portuguese nation-wide study on hospitalisations with burns highlights that 90% of all burns were due to hot liquid or object and a major impact of patients younger than 2 years old in this age group. Urban vs rural difference in hospitalization rate should also be considered for further health inequalities’ studies. As conclusion, ongoing attention needs to be dedicated to paediatric burn prevention and safety cost-effective strategies, particularly in relation to scalds, to further reduce the incidence of burn hospitalisations in children and the associated hospital costs.