【Objective】To evaluate the diagnostic values of multi-detector spiral computed tomography（MDCT）in pediatric sa? crococcygeal tumors（SCT）and to improve the diagnostic ability.【Methods】54 children（22 male and 32 female，age between 1 day and 16 years old）with pathologically confirmed SCT were involved in our study. All of them received 64-row spiral Computed Tomog? raphy before surgery，CT characteristics and clinical data were retrospectively analyzed.【Results】Pediatric SCT are more common in female children under four years old，with the germ cell tumors most common，followed by neurogenic tumors. Among the 54 SCT，39 cases were malignant and 15 were benign（malignant：benign = 2.60∶1）. In CT image findings，37 cases（68%）were mainly solid mass，with 31 cases confirmed malignant by pathology. 8 cases（15%）were mainly cystic，with all of them confirmed benign by pa? thology. 9 cases（17%）were cystic-solid or with obvious necrosis in solid mass，with 8 cases confirmed malignant by pathology. 【Conclusion】Malignant pediatric SCT are more common than benign SCT. Most malignant SCT are mainly solid mass or cystic-solid or with obvious necrosis in solid mass，and most benign tumors are mainly cystic. Combined with clinical data，MDCT can help to cor? rectly diagnose SCT before surgery.