The Australian Childhood Immunisation Register (ACIR) commenced operation in January 1996 and provides a comprehensive database of children's immunisations in Australia. The ACIR enables implementation of an immunisation recall and reminder system and improved surveillance and reporting of immunisation coverage. Before the introduction of the ACIR, the methods used in assessing coverage varied widely in design and quality, with few studies measuring coverage at national or statewide level. This is a systematic review of the scope and reliability of estimates of immunisation coverage available in Australia from 1990 to 1998. A total of 108 studies were identified of which 51 were classified as higher quality based on a range of criteria including whether they had a response rate of 50% or better.