OBJECTIVE: The aim of this study was to determine the incidence of type 1 diabetes among children aged 0-14 years in the Avalon Peninsula in the Canadian Province of Newfoundland. RESEARCH DESIGN AND METHODS: This was a prospective cohort study of the incidence of childhood type 1 diabetes in children aged 0-14 years who were diagnosed with type 1 diabetes from 1987 to 2002 on the Avalon Peninsula. Identified case subjects during this time period were ascertained from several sources and verified using the capture-recapture technique. Data were obtained from the only pediatric diabetes treatment center for children living on the Avalon Peninsula. RESULTS: Over the study period, 294 children aged 0-14 years from the Avalon Peninsula were diagnosed with type 1 diabetes. The incidence of type 1 diabetes in this population over the period 1987-2002 inclusive was 35.93 with a 95% CI of 31.82-40.03. The incidence over this period increased linearly at the rate of 1.25 per 100,000 individuals per year. CONCLUSIONS: The Avalon Peninsula of Newfoundland has one of the highest incidences of type 1 diabetes reported worldwide. The incidence increased over the 16-year study period.