Introduction: Despite increasing incidence of early onset colorectal cancer (EOCRC), limited literature is available regarding the distribution of polyps in younger people. The aim of our study was to evaluate the distribution of polyps in young versus older patients. Method: From a retrospective colonoscopy data set of 16,394 patients having colonoscopy undertaken over a six year period, a random, stratified sample was taken. Information collected included polyp location, type, largest polyp size, presence of high-grade dysplasia and carcinoma. Result: 907 colonoscopies with polyps were identified. 304 were in patients under 50 years of age and 602 in patients 50 years or older. 474 were male (median age 58) and 433 females (median age 60). In the < 50 group median age was 41 years and in the ≥50 group median age was 67 years. In patients <50, 236 had left sided polyps, of which 87 also had right sided polyps, and 60 had right sided polyps only. In patients <50 with left sided polyps there was a 37% chance of finding a right sided polyp. In patients ≥50, 431 had left sided polyps, of which 225 also had right sided polyp, 154 had right sided polyps only. In patients ≥50 with a left sided polyp there was a 52% chance of finding a right sided polyp. There was no difference in polyp distribution between Maori and non-Maori in either age category. Conclusion: This study demonstrates the distribution of polyps in young people is predominately left sided. The likelihood of finding a right sided polyp, in patients with a left sided polyp, increased with increasing age. Patients diagnosed with left sided polyps using flexible sigmoidoscopy warrant follow up colonoscopy, regardless of age.