Objective: To describe the content and structure of health and medical news and current affairs reportage on free-to-air television in Sydney, New South Wales. Design and setting: Review of content of all health-related evening news and current affairs items recorded over 47 months (May 2005 - March 2009). Main outcome measures: Number and length of health-related items on news and current affairs programs, and topics covered in these (21 broad content areas and the leading 50/237 specific content areas); use of news actors, soundbite duration and apparent news triggers. Results: 11 393 news items and 2309 current affairs items were analysed. Health news items lasted a median of 97 seconds. In a randomly selected sample of 251 items, items featured a mean of 2.2 news actors (3.9 in longer current affairs items). Median soundbite duration was 7.2 seconds for news items and 8.9 seconds for current affairs items. People affected by disease or injury were the most commonly featured news actors (84% of items), followed by experts and health prof essionals (56%). Many items (42%) appeared to be trigged by incidents, but a further 42% could have been triggered by press releases and other forms of publicity. Conclusions: Health workers wishing to participate in news coverage should be aware that complex issues are reduced to fit the time constraints and presentational formulae of the news media. Advocates should plan their communication strategies to accommodate these constraints.