Objective Dietary eicosapentaenoicacid (EPA) and docosahexaenoic acid (DHA) are found in the highest concentrations in fish and seafood. As important nutrients for brain and eye development and function, their consumption levels are of public health interest, especially in children. This study was conducted toexamine children’sreported consumption of fish and shellfish as well as EPA and DHA intake. Methods Secondary analysis of dietary intake (24-hour recall) and Food Frequency Questionnaire (FFQ) data ascertaining habitual fish and seafood intake of 2-18 year olds (N=13,441) participating in the 2003-2004, 2005-2006, 2007-2008, and 2009-2010 National Health and Nutrition Examination Survey (NHANES). All analyses were survey design corrected and weighted (one-day dietary intake weight) and conducted for the total sample by age group (2-5, 6-11, 12-18 year olds); analysis was conducted for EPA and DHA combined. Results Less than 50% of the children consumed fish (49.0%) or shellfish (35.9%) and only 0.3% of the population consumed fish high in EPA and DHA. Children consumed, on average, less than 25% of the recommended amount of EPA and DHA. The foods that contributed the highest average of EPA and DHA to the diet were canned sardines, cooked salmon, and fried carp. The EPA and DHA-containing foods consumed by at least one child in the population with the highest EPA and DHA densities were sturgeon roe, baked/broiled mackerel, and sardines. Conclusions Results of this nationally representative study of 2-18 year olds show that children had suboptimal consumption of fish and shellfish, and EPA and DHA reported intakes were much below the recommended amounts. Further research is needed to examine the barriers to higher fish and shellfish consumption and to develop effective ways to increase children’s dietary intake of EPA and DHA. Introduction The human body has the ability to elongate and desaturate alphalinolenic acid (ALA) to the long chain omega-3 polyunsaturated fatty acids (n-3 PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) [1-3]. However, Western diets are low in n-3 PUFAs, specifically ALA found in plant oils and EPA and DHA found in oily fish [4-6]. In the United States (US), the mean intake of n-3 PUFAs is 0.7% of total energy consumed [7], and intake in adults is very low with a median intake of EPA and DHA only contributing 0.05% of total dietary energy[7, 8]. Even individuals with low fish consumption have greater n-3 PUFA status than those individuals who do not consume any fish [9]. Western diets low in n-3 PUFAs and high in n-6 PUFAs contribute to poor brain development and function [4, 10]. It is uncertain if the rate of DHA synthesis in the human body is sufficient to support optimal brain and retinal development, and these PUFA swould ideally be provided in the diet [11]. DHA is the major n-3 PUFA esterified in glycerophospholipids through the action of acyl-CoA synthases and acyl-CoA:lysophospholipid acyltransferases [12], that forms the structural matrix of brain grey matter and retinal membranes [13, 14]. In addition, dietary intake of n-6 PUFAs play a role since n-6 PUFAs interact and compete with n-3 PUFAs in the fatty acid metabolic pathway [15-21].