BACKGROUND: Greulich and Pyle standards are the most widely used age estimation standards all over the world. The applicability of the Greulich and Pyle standards to populations which differ from their reference population is often questioned. This study aimed to assess the reliability of Greulich and Pyle (GP) method for determination of age of children at Debre Markos Referral Hospital, East Gojjam Zone, Ethiopia. SUBJECTS AND METHODS: Hospital based cross sectional study design was applied to children who came to Debre Markos Referral Hospital from May to October 2015 and fulfilled the inclusion criteria of the study. The data was analyzed using SPSS version 20 and medcalc version 15 softwares. Significance was set at α = 0.05. RESULTS: A total of 108 radiographs were analyzed.  Chronological age in most of the children   was under estimated. The mean under-estimation was 11.8 months in the female sample and 8.7 months in the male sample. Greulich and Pyle method became inapplicable for the sample at 16 years for females and 16.5 years for males and later. Delay in skeletal maturation was observed in both sexes, but the females in the sample matured earlier than the males. CONCLUSION: The findings of this study suggest against the applicability of GP atlas which were not directly applicable to an East Gojjam Zone population. Large scale studies should be planned and nationwide guideline, and atlas which can easily be used throughout the country should be developed. 
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KEYWORDS: Chronological age, bone age, Greulich and Pyle