Pediatric Priority Process (PEPP) is a triage system derived from the South African Triage Scale. It was developed by healthcare professionals at the Queen Silvia Children's hospital in Gothenburg. PEPP is a four-level triage system with two parts: vital parameters and warning symptoms. The aim of the study was to compare the amount of overtriage and the specificity for children in need of hospitalization in PEPP compared to RETTS-p. Our study shows that PEPP yields significantly fewer children with a high priority and has a higher specificity than RETTS-p. Senior triage nurses judged PEPP to have a higher accuracy, and the system triages children in need of supplemental oxygen higher than RETTS-p. We conclude that PEPP has high patient safety, and the next step is to implement it at our pediatric emergency department and to continue research for further validation.