Objective: Joint pain is a common complaint in childhood and is frequently associated with benign or non-rheumatologic conditions, while rheumatologic diseases are less common. This study aimed to identify the causes of joint pain in patients referred to a pediatric rheumatology outpatient clinic at a tertiary care hospital and to determine the characteristics of patients that necessitate further investigation. Methods: This study evaluated patients who were referred to pediatric rheumatology outpatient clinic with complaints of joint pain between 01.07.2022-01.01.2023. Demographic data, pain characteristics, clinical findings, laboratory data and final diagnosis were reviewed from medical records. Results: Of the 254 pediatric patients included in the study, 57.1% were female, and the mean age was 10.5±4.6 years. The median age at onset of joint pain was 10 (range:5.3–13.5) years. Rheumatologic disease was diagnosed in 7.9% of patients, non-rheumatologic conditions in 46.9%, and no pathology was identified in 45.3% of patients. Children with rheumatologic diseases exhibited a significantly longer duration of symptoms (median 9 months [2.4–21], p<0.001) and a higher prevalence of daily pain (75%, p=0.001). Inflammatory pain charactesistics were significantly more prevalent in rheumatologic disease group, including pain that improved with activity (40%, p<0.001), lack of response to rest (40% responsive to rest, p<0.001), nocturnal pain causing sleep disturbance (10%, p=0.007), and pain unresponsive to massage (5%, p=0.01). Conclusion: Minority of children presenting with joint pain were diagnosed with a rheumatologic disease. In these patients, joint pain tended to be more frequent and persistent, and exhibited inflammatory characteristics. A careful and systematic evaluation based on detailed medical history and comprehensive physical examination in children with joint pain may substantially reduce the need for unnecessary advanced diagnostic testing.