Objectives To identify the ongoing service needs of young people with attention-deficit hyperactivity disorder (ADHD). Design A case note review of all children aged 14 and over with a diagnosis of ADHD seen in a paediatric neurodisability clinic. Participants 139 young people aged 14 years and over on 1 September 2007 with a diagnosis of ADHD were identified from ADHD service user databases at a centre in Sheffield, UK. Results 102 young people were on medication for ADHD and just over 50% had well controlled ADHD. 71% had at least one co-morbid condition. 46 patients had had intervention from child and adolescent mental health services and 17% had offended. 37% were likely to need transition to adult mental health services as soon as they left paediatric services and 36% would benefit from the expertise of a clinical nurse specialist, either to support a general practitioner (GP) or adult mental health professionals. Conclusions The recent National Institute for Health and Clinical Excellence guidelines highlight the need to provide transition services for young people with ADHD who have continuing impairment. The need for services for adults with ADHD is also recognised. The study confirms and refines the nature of this need in the local population. Young people with mental health problems in addition to their ADHD will need support from adult mental health services. However, a significant group of young adults are likely to be managed well by specialist nurses working with GPs in a primary care setting or adult mental health.