Objective: To evaluate clinical presentation, diagnosis and treatment of brain abscess in pediatric age group.Material and Methods: This observational study was conducted at the department of Neurosurgery / pathology, Post-graduate medical institute, Lady Reading Hospital Peshawar from Jan 2011 to December 2013. A total of 21 consecutive patients who undergone surgery (aspiration / excision) for brain abscess with age less than 14 years were included in the study irrespective of their gender. Those treated conservatively or age more than 14 years were excluded from the study.Results: We had total 21 children who underwent surgery for brain abscess in the study period. There were 62% males and 38% females. Most of the patients presented with fever (66.7%) and headache / vomiting (61.9%). Otitis media (33.3%) and cyanotic heart disease (23.8%) were the common predisposing factors. CT brain with contrast was done in all the patients with brain abscess. Most of the children (52.4%) with brain abscess were offered bur-hole aspiration. In 57.1% patients the culture report was positive. The commonly identified orga-nisms were streptococci in 41.7 % cases and staphalococci in 25%.Conclusions: We concluded from this study that otitis media and cyanotic heart disease were the common pre-disposing factors for pediatric brain abscess. The common presenting features were fever followed by headache / vomiting. CT brain with contrast is the investigation of choice to diagnose brain abscess. Most of the children with brain abscess needs aspiration. Culture was positive in most but not all the cases
