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Unstable fractures of the pelvic ring in children are usually treated conservatively. The results of this therapy were evaluated retrospectively in 17 children who had been under 13 years old at the time of injury. All but 4 of the children had additional injuries. The pelvic fracture had a rotational instability in 9 patients and was vertically unstable in 8 patients. The follow-up period was 2-25 years. Clinical results were good provided that there was a good radiological result with only minimal asymmetry of the pelvic ring or none at all. Functional leg length differences and scoliotic deformation of the lumbar spine due to traumatic and/or growth-related asymmetry of the pelvis caused chronic low back pain in 5 of 8 patients. Only fracture healing in a near-anatomical position can ensure good clinical results in pelvic fractures in children. Considering the results presented here, operative reduction has to be recommended when reduction cannot be achieved by conservative means. However, there is no proof that open reduction and internal fixation provide better results than conservative therapy in unstable pelvic ring fractures in children.