The authors report their anesthesiological experience in 88 cases of transluminal balloon dilatation of esophageal strictures in children. The most serious problems are caused by the need to repeat the dilatation process (up to a maximum of 24 times in one patient) and to the risk of extrinsic mechanical compression of the trachea with consequent transient anoxia. Good sedation was achieved using premedication with haloperidol and diazepam, but was not sufficient to avoid the child's anxiety on entering the operating theatre. Anesthesia using ketamine plus fentanyl, combined with tracheal intubation gave good results in almost all cases, but marked bradycardia was observed in several patients during balloon dilatation. In conclusion, although the technique itself is simple to perform, very careful anesthesia is required to avoid the risk of serious intraoperative complications.