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Oesophageal strictures in the paediatric population pose a significant clinical challenge, with affected children often requiring recurrent endoscopic dilations to manage their condition. 1 This retrospective study aimed to analyse the demographics, aetiologies, management, and outcomes of children treated for oesophageal strictures at a tertiary care centre in London over a 14-year period. We reviewed medical records of patients aged 18 years or younger who underwent oesophageal dilatation for benign oesophageal strictures between January 2010 and September 2024. Data collected included patient demographics, stricture aetiology, number of dilatations, need for adjunctive interventions (e.g., stent placement, intralesional steroid injections or topical mitomycin application), and treatment outcomes.Our findings revealed that anastomotic strictures were the most prevalent (39/55, 71%), followed by corrosive (4/55, 7.3%), and peptic strictures (4/55, 7.3%).Endoscopic balloon dilatation was demonstrated to be a highly effective primary treatment approach, achieving successful outcomes in the majority of cases (36/55, 65.45%).Additionally, three patients with successful treatment outcomes necessitated a combination of dilatation and stent placement, while two others required dilatation in conjunction with medication, and one patient necessitated dilatation, medication, and stent insertion to attain a satisfactory result. Notably, patients with caustic strictures presented significant management challenges, often necessitating multiple dilatations (ranging from 15 to 56) and adjunctive interventions such as stent placement, steroid injections and mitomycin application.Of the 55 patients included in the study, 15 (27%) had evidence of dysmotility on barium swallow, and 13 (23.6%) had gastroesophageal reflux disease confirmed by pH/impedance testing.Furthermore, our study found that eosinophilic oesophagitis was a contributing factor to oesophageal dysmotility in 3 patients (5.45%), all of whom had an underlying aetiology of anastomotic strictures following repair of oesophageal atresia with tracheoesophageal fistula. This observation holds clinical significance, as eosinophilic esophagitis can induce fibrosis and structural changes within the oesophagus, potentially exacerbating the severity and recurrence of oesophageal strictures.Successful long-term management of oesophageal strictures in children relies on the careful assessment and management of co-existing conditions, such as gastroesophageal reflux disease and oesophageal dysmotility, which are significant co-morbidities in this patient population.2 This study underscores the complexity and multifaceted nature of oesophageal strictures in the paediatric population, emphasizing the need for a multidisciplinary approach to optimize management strategies and long-term outcomes.