Aim:  Clinical features to identify infants at increased risk of recurrence after a primary episode of intussusception (IS) are poorly defined. Methods:  Prospective study of the clinical presentation, treatment and outcome in infants <2 years presenting with acute IS to the National Hospital of Pediatrics, Hanoi, over a 14‐month period (1 November 2002 to 31 December 2003). A retrospective review of medical records was performed to verify complete patient ascertainment. Results:  Five hundred ninety‐eight children were recruited, including 513 (86%) with a primary episode only and 53 (9%) with ≥1 recurrent episodes. Another 32 (5%) infants presented with recurrent IS, but the primary episode of IS occurred outside the study period. Estimated recurrence risk at 6 months following a primary episode was 14%. A pathological lead point was rare in primary (n= 1) and recurrent IS (n= 1). Most infants were successfully treated with enema reduction. Conclusions:  This study describes the natural history of recurrent IS in infants and may assist in interpreting data from post‐marketing surveillance following introduction of rotavirus vaccines.