To evaluate the postoperative complications within the first month among 20 pediatric liver transplant recipients between April 1990 and March 2003 we retrospectively studied their medical charts to gather demographic data; primary diagnosis; operative duration; perioperative transfusions; time to extubation; length of intensive care unit (ICU) stay; mortality; perioperative laboratory values; and postoperative complications including respiratory, infections, renal, neurological, cardiovascular, and gastrointestinal tract (GIT) complications.Ten male and ten female patients of mean age 8 ± 4 years had a mean operative duration, time to extubation, and length of stay in the ICU of 12.1 ± 2.3 hours, 11.1 ± 15.0 hours, and 7.2 ± 5.5 days, respectively. The most frequent postoperative complication was respiratory (n = 14, 70%), followed by infections (n = 13, 65%), renal (n = 8, 40%), neurological (n = 7, 35%), cardiovascular (n = 4, 20%), and GIT (n = 4, 20%) infections. The overall mortality rate was 25% (n = 5). Compared with patients who survived, those who died displayed significantly lower perioperative platelet counts (P < .05), as well as a significantly higher incidence of postoperative neurological disorders (P = .031), and cardiovascular complications (P = .032).