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Littoral cell angioma (LCA) is a rare primary splenic vascular tumor, originating from the littoral cells&lt;br /&gt;lining the red pulp sinuses of the spleen. There are only a handful of case reports of LCA in children to be found&lt;br /&gt;in the literature. We performed a retrospective analysis of the medical charts of pediatric patients with splenic&lt;br /&gt;lesions who were treated between 2005 and 2010 in the Pediatric Surgery Department of the Medical University&lt;br /&gt;of Bialystok. Surprisingly, LCA accounted for 37.5% of the splenic lesions found in our series. The majority of&lt;br /&gt;LCA tumors are benign, but given their malignant potential, splenectomy and long-term follow-up should be&lt;br /&gt;the gold standard for their management. We strongly support the use of further cross-sectional studies to properly&lt;br /&gt;elucidate the prevalence of littoral cell angioma of the spleen in the pediatric population.<br>Littoral cell angioma (LCA) is a rare primary splenic vascular tumor, originating from the littoral cells&lt;br /&gt;lining the red pulp sinuses of the spleen. There are only a handful of case reports of LCA in children to be found&lt;br /&gt;in the literature. We performed a retrospective analysis of the medical charts of pediatric patients with splenic&lt;br /&gt;lesions who were treated between 2005 and 2010 in the Pediatric Surgery Department of the Medical University&lt;br /&gt;of Bialystok. Surprisingly, LCA accounted for 37.5% of the splenic lesions found in our series. The majority of&lt;br /&gt;LCA tumors are benign, but given their malignant potential, splenectomy and long-term follow-up should be&lt;br /&gt;the gold standard for their management. We strongly support the use of further cross-sectional studies to properly&lt;br /&gt;elucidate the prevalence of littoral cell angioma of the spleen in the pediatric population.