This research examined the nature of children's trauma narrative themes and the relationship between these themes and concurrent and future trauma symptoms. Eighty-seven children aged 7-15 years, and their parents, participated following child exposure to a traumatic event requiring hospitalization. At 4-7 weeks post-trauma, a diagnostic interview was conducted with parents and a trauma narrative was obtained from the child. At 6 months post-trauma the diagnostic interview was re-conducted. Results provided only weak evidence of an association between dissociative trauma narrative themes and PTSD symptoms. Specifically, children who showed temporal disorganization, but not absence of emotion or dissociative amnesia, in narrative themes were more likely to report concurrent subsyndromal PTSD symptoms at 4-7 weeks post-trauma. Children who showed absence of emotion (or at least one dissociative theme) in the trauma narrative were more likely to show symptoms of hyperarousal, but not other symptoms of PTSD, at 6 months post-trauma. These findings have implications for understanding the role of dissociation and the development of PTSD in children.