OBJECTIVE: Retroperitoneal lymph node dissection (RPLND) in children with yolk sac tumor (YST) of the testis still remains controversial. Herein we present our experience in the management of children with stage I YST of the testis treated with RPLND or observation. MATERIALS: Between 1962 and 1989, 60 children with YST of the testis stage I were evaluated at our Institution. Only 46 were evaluated at 24 or more months, twenty-five (54,3%)underwent RPLND and 21 (45,7%) only observation. Mean age for the first group was 23.7 months (r:5-84) and for the second group 23,3 months (r:8-72). RESULTS: Of the pts that underwent RPLND 3 (12%) died of other causes (1 at post-op#1 due to bronchial spasm, pneumonia in 1 at 6 months and dehydration in 1 at 21 months); 17/25 (68%) pts are alive and without evidence of disease between 3 and 26 years follow-up. In the gourp of pts that underwent observation, 2 pts died of other causes (9,5%): meningitis and lymphatic leukemia, respectively, 12/21 pts (57,1%) are alive and without evidence of disease between 3 and 13 years follow-up. Furthermore, 5/25 pts (20%) treated with RPLND died because of disease progression, compared to 7/21 (33,4%) in the group observed. CONCLUSIONS: Our study suggests that children with stage I YST of the testis might benefit with RPLND, compared to a similar group of pts that were observed.