The pediatric surgeon in his work has to face a wide variety of diseases related to narrow areas of medicine. Particular difficulties are caused by the diagnosis and treatment of thyroid gland formations (TGF). The number of such patients is steadily growing both in the Russian Federation and in the Altai Territory, due to iodine deficiency, radiological and environmental pollution and other possible causes. In the Children’s Surgery Clinic of the Altai State Medical University, 101 children aged from 5 to 17 years were treated in the period from 2000 to 2017 due to thyroid lesions. The study included operated patients with both benign formations and with follicular and papillary carcinoma:. Depending on the case, a different volume of surgical intervention was used: mainly, hemithyroidectomy with isthmectomy and total thyroidectomy. In the work the analysis of own results of the treatment is carried out, comparison with widely known approaches of the management of patients with TGF is given. We are of the opinion that the desire for radicalism does not always yield the best results. Thus, we consider it quite justified to perform organ-preserving operations in both follicular and papillary thyroid carcinoma. Difficulties in deciding the extent of the intervention are also caused by the inability to differentiate the form of thyroid mass before the operation. In addition, the hormonal status of the child in the postoperative period requires special attention, and the use of hormonal therapy in the absence of hormonal disorders pushes to doubt its necessity. A number of features in the operational process allows achieving good results. Thus, the choice of tactics for treating children with thyroid disorders should be advisedly and carefully considered taking into account the characteristics of the child’s organism and the specific situation.