Purpose: Burns are a common mechanism of paediatric injury worldwide and are a notable cause of disability-adjusted life-years. Burns in children represent a unique challenge, due to the differences from adults in physical characteristics, physiology and psychology. Methodology: This retrospective cohort study examined trends of paediatric burns in New South Wales, Australia from 2010-22. It specifically focused on the changes in patterns of burn aetiology and patient characteristics, body area affected, total body surface area, first aid, location and management. This study also compared a ‘Pre-COVID-19’ and ‘Peri-COVID-19’ era to also analyse the impact of COVID-19 on the pattern of paediatric burns, as children are at higher risk of injury during times of social disruption. Results: Burns in children continue to be concentrated in the toddler and preschooler age group and the main mechanisms of injury remain as scald and contact burns. In recent years, there has been a rising trend of friction burns, alongside a fall in flame burns and severe burns. Management of paediatric burns has also evolved, with predominant use of ambulatory care and low rates of admission and operative intervention. Conclusion: Trends in burn injury continue to evolve with time and over the last decade in NSW, we have observed key changes in the pattern of paediatric burns, with evolving mechanisms of injury, reduced severity of burns and a shift towards ambulatory care.