In eight children with suspected osteoid osteoma, a percutaneous resection under CT guidance was performed. The specific drill resection system we currently use includes a 7-mm-diameter toothed drill. Osteoid osteomas were located in the appendicular skeleton in seven children and in the spine (second lumbar vertebral body) in one. All eight patients were successfully treated with complete relief of pain. There was no recurrence of symptoms during a follow-up period of 8-35 months. CT guidance was accurate enough to allow a focal bone excision, and no subsequent bone repair was needed. Histological confirmation was obtained in all cases. This simple and safe technique, when feasible, seems to be an effective means of treatment of osteoid osteoma in children.