Background and aims Liquid formulations are easy to swallow but they may have disadvantages such as a bad taste, preservatives or restricted storage conditions. These disadvantages may be overcome by oral solid flexible dosage forms such as powders or mini-tablets. The aim of this study was to investigate the acceptance and preference of four oral dosage forms in children aged 1–4 years in the Netherlands. Methods Parents administered four different placebo formulations: a 4-mm round, uncoated mini-tablet, powder, suspension and syrup at home to their (healthy) child twice on one day following a randomized cross-over design. They were asked to report the child acceptance by the result of the intake and by a child acceptance score on a 10-cm visual analogue scale (VAS). At the end of the study parents were asked to report the child and parent preference. Results 183 children were included and 151 children were evaluated. The mini-tablet was fully swallowed in 97% of all cases, the powder 81%, the suspension 86% and the syrup 83%. The mean VAS-scores were: tablet 9.01; powder 8.00; suspension 7.78; syrup 8.04. The mini-tablet was significantly better accepted than the three other dosage forms (p<0.05). The same pattern was observed when only the first intake was considered given a carry-over effect. Children and parents preferred the tablet and syrup over the suspension and the suspension over the powder (p<0.05). Conclusions All dosage forms were well accepted, but the mini-tablets were the best accepted and preferred dosage form.