Objective To explore the relevant prognostic factors for children with sacrococcygeal teratoma (SCT). Methods A retrospective analysis of 65 hospitalized SCT children was performed between March 2011 and April 2019. Presence or absence of tumor recurrence and postoperative defecation and urination functions were recorded. Those with tumor recurrence, defecation or urination dysfunction belonged to group of poor prognosis. And the remainders were classified as group of good prognosis. Risk factors included operative age, tumor size, Altman type, surgical route and spillage of tumor. Results Among them, 7 cases had tumor recurrence, including type Ⅰ (n=2), type Ⅱ (n=3), type Ⅲ (n=1) and type Ⅳ (n=1). There were mature teratoma (n=2), immature teratoma (n=4) and malignant teratoma (n=1). And 7 cases developed constipation, including type Ⅰ (n=1), type Ⅱ (n=2), type Ⅲ (n=3) and type Ⅳ (n=1). There were mature teratoma (n=2), immature teratoma (n=4) and malignant teratoma (n=1). Three children had recurrent urinary tract infections, including type Ⅰ (n=1), type Ⅱ (n=2), type Ⅲ (n=3) and type Ⅳ (n=1). There were mature teratoma (n=2), immature teratoma (n=4) and malignant teratoma (n=1). Among 61 SCT children, prognosis was good (n=48) and poor (n=13). Univariate analysis indicated that Altman type, surgical roué, spillage of tumor and pathology were poor risk factors. And multi-factorial Logistic regression analysis revealed that pathological type (OR=17.322, 95%CI: 2.723-110.182) and Altman type (OR=6.133, 95%CI: 1.281-29.374) were independent risk factors of poor prognosis (P﹤0.05). Conclusion In SCT children, prognosis is correlated with defecation and urination function and tumor recurrence. Altman type, spillage of tumor and pathology are the relevant prognostic factors. Thus maintaining the integrity of tumor and minimizing the injuries of pelvic floor muscles and nerve may improve the prognosis of SCT in children. [ABSTRACT FROM AUTHOR]