Ninety‐one children that were subjected to transabdominal radical nephrectomy are reviewed. The patients' ages ranged from 20 days to 10 years. Forty cases had a right side tumor and 44 a left side tumor; bilateral tumor incidenc e was 7.70% (7 cases). The tumor weight incidence was 75% for ⩾500 g and 37.5% for ⩾1,000 g. Incidence of local extension of the disease was 21.98%. Intraoperative complications were 12 ruptures of the kidney capsule, 1 laceration of the cecum, 1 opening of the pleura, 1 section of the superior mesenteric artery, and 1 section of the right common iliac artery. The mortality rate in unilateral surgery, because of intraoperaive massive hemorrhage, was 3/83 (3.61%). One patient with bilateral tumor died because of accute renal insufficiency and sepsis. One patient with caval thrombus which extended up to the right atrium died because of intraoperative massive pulmonary embolism. Copyright © 1990 Wiley‐Liss, Inc., A Wiley Company