The smaller vascular diameters of pediatric patients are more prone to vascular complications when compared with adults. Vascular complications of 21 pediatric patients (16 male, 5 female; aged 8.3 ± 5.05 years) who had received liver transplantation between September 2001 and June 2004 were retrospectively analyzed. During the first postoperative week, vascular patency was evaluated twice per day with Doppler ultrasonography and once per day during the second week. Computerized tomographic angiography and/or conventional angiography were performed when needed according to Doppler findings. Donors included mothers (n = 10), fathers (n = 6), uncles (n = 2), brother (n = 1), grandfather (n = 1), and cadaver (n = 1). Etiologies of chronic liver disease for patients included Wilson disease (n = 9), biliary atresia (n = 4), progressive familial intrahepatic cholestasis (n = 4), fulminant hepatitis (n = 2), hepatitis B (n = 1), and Alagille syndrome (n = 1). Hepatic arterial thrombosis (HAT) was diagnosed in 4.7% (n = 1), hepatic arterial stenosis (HAS) in 19.4% (n = 4), and hepatic arterial dissection in 4.7% (n = 1) of the patients. Thrombectomy and reanastomosis were performed in 1 patient with HAT. In patients with HAS, 1 balloon angioplasty, 1 balloon angioplasty and endoluminal stent placement in the same procedure, and 1 reanastomosis were performed. The final patient with HAS had an intimal dissection that occurred 24 hours after balloon angioplasty, which was treated with endoluminal stent placement. Mean follow-up of the patients with vascular complications was 9.5 ± 5.7 (range, 4-18 months). Overall mortality rate for these pediatric patients was 14.1% (3/21); however, there was no mortality due to vascular complications. Posttransplant routine daily Doppler ultrasonographic evaluation is an effective choice for prompt diagnosis of vascular complications commonly seen following liver transplantation. Surgical revascularization is required for early vascular complications, whereas late complications may be treated with balloon angioplasty and/or endoluminal stent placement.