Objective: Determine the incidence and prevalence of diabetes in children <15?yr in Fiji. Methods: Data on all new cases from 2001 to 2012 was collected from the three paediatric diabetes services through the International Diabetes Federation Life for a Child Program. There was no formal secondary ascertainment source, however the medical community is small and all known cases are believed to be included. Results: Forty-two children aged <15?yr were diagnosed from 2001 to 2012. Twenty-eight were type 1 (66.7%), 13 type 2 (31.0%), and 1 (2.4%) had neonatal diabetes (INS gene mutation). For type 1, the mean?±?standard deviation (SD) age of diagnosis was 10.2?±?2.9?yr, with similar proportions of males and females. Four (14.3%) were native Fijians and 24 (86.7%) were of Indo-Fijian descent (p?<?0.001). The mean annual incidence of type 1 in children <15?yr was 0.93/100?000 and prevalence in 2012 was 5.9/100?000. There was no evidence of a rise in incidence, but low numbers would preclude recognition of a small increased rate. For the 13 cases of type 2 diabetes, the mean SD age of diagnosis was 12.2?±?2.7?yr, 85% were female (p?<?0.01), and 85% were of Indo-Fijian descent (p?=?0.001). The mean annual incidence of type 2 was 0.43/100?000 and 2012 prevalence was 2.4/100?000. No child with diabetes aged <15?yr died during the 12-yr period. Conclusions: The incidence of type 1 diabetes in Fiji is very low. Furthermore, its occurrence is markedly more frequent in Indo-Fijians than in native Fijians. Type 2 and neonatal diabetes also occur.