Childhood cancers (age at diagnosis: 0–14 years) comprise a variety of malignancies, with incidence varying worldwide by age, sex, ethnicity and geography, that provide insights into cancer etiology. A total of 1,334 childhood cancers registered in population‐based cancer registry, Chennai, India, during 1990–2001 and categorized by International Classification of Childhood Cancer norms formed the study material. Cases included for survival analysis were 1,274 (95.5%). Absolute survival was calculated by actuarial method. Cox proportional hazard model was used to elicit the prognostic factors for survival. The age‐standardized rates for all childhood cancers together were 127 per million boys and 88 per million girls. A decreasing trend in incidence rates with increasing 5‐year age groups was observed in both sexes. The top 5 childhood cancers were the same among boys and girls: leukemias, lymphomas, central nervous system neoplasms, retinoblastomas and renal tumors. The highest 5‐year absolute survival was observed in Hodgkin's disease (65%) followed by Wilm's tumor (64%), retinoblastomas (48%), non‐Hodgkin's lymphomas (47%), osteosarcomas (44%), acute lymphoid leukemia and astrocytoma (39%). Multifactorial analysis of age at diagnosis and sex showed no differences in the risk of dying for all childhood cancers. Completeness of treatment and type of hospital combination emerged as a prognostic factor for survival for all childhood cancers together (p < 0.001), acute lymphoid leukemia (p < 0.001) and non‐Hodgkin's lymphoma (p = 0.04). A Childhood Cancer Registry with high‐resolution data collection is advocated for in‐depth analysis of variation in incidence and survival. © 2008 Wiley‐Liss, Inc.