A clinical analysis was made of 42 pilomatricoma in 34 children treated, from January 1980 to August 1996 at the Department of Pediatric Surgery, Hanyang Diversity. The gender ratio was 13 to 21 with female preponderance. The average age at presentation was 7 years 3 months(range 8 months to 19 years old). The time average interval from onset to excision was 9.8 months. The predilection site was neck, upper extremities, face, trunk and lower extremities in the decreasing order of frequency. The masses were less than 3cm in diameter and there was no correlation between age at presentation and size of the mass. Of the six children with multiple lesions, two presented with multiple lesions initially and four presented with second lesion metachronously after excision of the primary lesions. Two girls had cysticercosis and von Recklinghausen's disease respectively in association with a pilomatricoma. All lesions were encapsulated subcutan6eous masses which were clearly distinguished from surrounding tissue, and 4 of them had pigmentation, ulceration, skin disruption and hemorrhagic changes in the overlying skin. Microscopically the mass was composed of basophilic cells and eosinophilic shadow cells. Calcification, foreign body giant cell, ossification, focal cystic, inflammatory or necrotic changes were also seen.