Children with many somatic complaints seem to report problems with emotion identification and communication (‘alexithymia’). The aim of this study was to verify whether children with somatic complaints do indeed show signs of alexithymia. We compared 35 children (M age = 10.99, SD = 13 months) with many somatic complaints with 34 children (M age = 11.03, SD = 12 months) reporting few complaints on the basis of a self-report alexithymia scale and tasks that require the skill to identify and communicate emotions: an emotional attention task, a structured interview about own emotions, and a mixed-emotion task. Children were also asked about the intensity of the reported emotions. Compared to children with few complaints, children with many complaints seemed to have higher self-reports of alexithymia. However, these results were explained by difficulty in communicating negative internal states and experiencing indefinable internal states, rather than difficulty in identifying emotions. In addition, children with many complaints reported higher intensities of fear and sadness. The children did not differ in their attention to emotions or causes of emotions. Children with many somatic complaints more often described previous emotional experiences and showed better abilities in identifying multiple emotions. Children with many somatic complaints thus show more negative emotional processing, but the alexithymia-hypothesis was unsupported.