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Objective: To examine outcomes and associated risk factors for children who undergo surgery for lung hydatidosis (LH)., Study Design: Through a retrospective and analytical-aim-study, over a period of 35 years in 2 surgical departments, we reported all operative cases for LH in children, regardless of cyst number, location, and aspect. Univariate and multivariable analyses were used to assess variables potentially predictive of postoperative morbidity., Results: In total, 456 children with a mean age of 10.3 years were included. We performed 544 surgical procedures for 704 cysts with a median size of 60 mm (range 10-200 mm). Thirty-six percent of cysts were complicated. Conservative surgery was performed in 98.5% of cases and anatomical lung resection was required for 1.47% of children. Postoperative complications occurred in 24.4% of children and one death was recorded (0.2%). After multivariable analysis, the independent-associated morbidity risk factors for postoperative morbidity were anatomical lung resection, intensive care unit stay, complicated cyst, a cyst size ≥60 mm, ≥3 bronchial fistulas, associated liver hydatidosis, and the presence or occurrence of empyema during surgery., Conclusions: Conservative surgery sparing the lung parenchyma is the treatment of choice for lung hydatidosis and is associated with a low mortality rate. Knowledge of independent risk factors for morbidity may help clinicians to manage children with LH more adequately and improve postoperative outcomes., Competing Interests: Declaration of Competing Interest All authors admit that they have not received any funding support to elaborate this work. All authors declare having no conflict of interest for this work., (Copyright © 2024 Elsevier Inc. All rights reserved.)