ObjectiveTo explore the image characteristics, microsurgery methods and the prevention and treatment of postoperative complications of craniopharyngioma in children.MethodsClinical information of 19 cases of pediatric craniopharyngioma receiving surgical procedure, including image characteristics, surgical approaches and postoperative complications, were analyzed retrospectively.ResultsTotal resection was performed in 14 cases(73.7%）, subtotal resection in 5 cases（26.3%）.Three different approaches were used, including the fronto-basal interhemispheric approach(10 cases), the pterion approach(7 cases), and the transcallosal-interforniceal approach(2 cases).The postoperative complications were as follows: diabetes insipidus in 15 cases, electrolyte disorder in 14 cases, hypopituitarism in 10 cases, epilepsy in 5 cases, intracranial infection in 4 cases, and central high fever in 3 cases.There was no case of death in peroperative period.19 cases were followed up.10 cases of hypopituitarism needed long-term hormone replacement, 2 cases died because of hypopituitarism.ConclusionPreoperative image evaluation, proper choice of surgical approach and active prevention and therapy of postoperative complication are important links in improving the prognosis of craniopharyngioma.