We reviewed the findings in twenty children and adolescents who had meralgia paresthetica, a common entity in adults that has only rarely been reported in children. Ten patients had bilateral involvement; thus, the study included thirty lesions. Twenty-four lesions were eventually treated with open decompression of the lateral femoral cutaneous nerve; the results of twenty-one of these operations were followed for at least two years. The presenting symptom was severe pain resulting in marked restriction of activities. The pain could be reproduced with palpation of the nerve, and a trial injection of Xylocaine (lidocaine) always produced transient relief of symptoms. The average age at the onset of the symptoms was ten years (range, one to seventeen years); the diagnosis was missed initially in ten patients, which resulted in multiple, unnecessary diagnostic tests being done. The average duration of the symptoms before the patient was first seen was twenty-four months (range, two to eighty-four months), and the average duration of follow-up after the twenty-one operations was thirty-eight months (range, twenty-five to sixty months). Fourteen of the twenty-one operations led to an excellent result, with complete relief of pain and no restriction of activities; five led to a good result, with occasional pain but no limitation of sports or other activities; and two led to a fair result, with pain that interfered with sports activities but not with walking. We believe that meralgia paresthetica is much more common in children than has been previously recognized.(ABSTRACT TRUNCATED AT 250 WORDS)