The surgical management of 10 patients with staphylococcal pericarditis is described. Of the 10, seven were children aged 12 years or under. A variety of procedures was used to drain the pericardium at open operation; these included left anterior thoracotomy, left anterolateral thoracotomy, median sternotomy, and the transdiaphragmatic approach to the pericardium. The pathological findings at operation are described. Two patients died; one of the deaths was related to the operation, the other was not. The remained eight patients were ultimately well although two required reoperation before recovery was achieved. After the initial diagnosis of pyopericardium, early consideration of operative drainage is advocated. An effective means of surgical management is dependent, open drainage of the pericardium approach by the transdiaphragmatic route.