Using the metaphor of a message in a bottle as a framework and sending an S.O.S. to adults, the question of what are the three biggest needs of children and young people was asked. Data consisting of 107 important needs of children and young people was collected from 36 children and young people both in and out of hospital: in hospital by chaplains and other health care professionals, and out of hospital by children and youth work undergraduate students. This was a convenience sample across the United Kingdom with the majority of respondents in the Midlands. The data were coded and then thematically analysed and separately compared to Maslow’s hierarchy of needs. Emotional needs was the largest theme for hospitalised children and young people and relationship needs for the non-hospitalised children and young people. For both groups Maslow’s level 3 need of belonging was the greatest averaging at just over half the needs shared. A discussion of the results of the analyses identifies some ways in which the needs of hospitalised children and young people may differ, identifying some implications for practice.