Childhood cancer mortality has sharply declined in most economically developed countries over the last years, whereas no substantial changes in the incidence have been observed. In Catalonia (Spain), childhood cancer mortality showed a considerable decline until 1992, but incidence trends have not been analysed in this population. To assess both recent incidence and mortality trends in this population, we analysed childhood (0–14 years) cancer data from the population-based Tarragona Cancer Registry and from the Mortality Registry of Catalonia (Spain) from 1980 to 1998. All cancer mortality decreased by –2.6% annually in boys (95% confidence interval, 95% CI –3.7, –1.6) and –3.7% in girls (95% CI –4.9, –2.5). Mortality due to leukaemia decreased annually –3.0% in boys (95% CI –4.7, –1.4) and –4.4% in girls (95% CI –6.3, –2.4). Mortality for brain tumours showed a reduction of –3.2% in boys (95% CI –5.5, –0.9) and of –4.4% in girls (95% CI –6.3, –2.4). No significant trend in incidence rates, either in boys or in girls, was observed (annual per cent of change for all cancers –0.5%, 95% CI –3.5, 2.7, in boys and 1.7%, 95% CI –1.9, 5.5, in girls). These results suggest an improvement in both childhood cancer diagnosis and treatment, which may explain current higher childhood cancer survival rates.