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Background Nutrition labeling of menus has been promoted as a means for helping consumers make healthier food choices at restaurants. As part of national health reform, chain restaurants will be required to post nutrition information at point-of-purchase, but more evidence regarding the impact of these regulations, particularly in children, is needed. Purpose To determine whether nutrition labeling on restaurant menus results in a lower number of calories purchased by children and their parents. Methods A prospective cohort study compared restaurant receipts of those aged 6–11 years and their parents before and after a menu-labeling regulation in Seattle/King County (S/KC) (n=75), with those from a comparison sample in nonregulated San Diego County (SDC) (n=58). Data were collected in 2008 and 2009 and analyzed in 2010. Results In S/KC, there was a significant increase from pre- to post-regulation (44% vs 87%) in parents seeing nutrition information, with no change in SDC (40% vs 34%). Average calories purchased for children did not change in either county (823 vs 822 in S/KC; 984 vs 949 in SDC). There was an approximately 100-calorie decrease for the parents postregulation in both counties (823 vs 720 in S/KC; 895 vs 789 in SDC), but no difference between counties. Conclusions A restaurant menu-labeling regulation increased parent's nutrition information awareness, but did not decrease calories purchased for either children or parents.