Cholesteatoma of the middle ear in children is a current topic and authors are not yet unanimous as far as surgical treatment is concerned. We report our experience on 160 cases of cholesteatoma observed in 150 children aged from 4 to 15 years old. The first complications represent the reason for consulting in 36% and bilateral affection in 15% of the cases. We have practised the "open technique" in 62%, the "closed technique" in 38% of the cases. The "second look" operation for a residual cholesteatoma, or a recurrence constitute 26% of cases after the closed technique. Our choice of the open technique is explained by the social and economic standard of the patients, the state of the mastoid, the frequency of the complications mainly intracranial ones, and the types of lesions encountered during the operation. According to this serie, we can review the data of the literature, and analyse the different points of view.