Fibroblastic lesions in children present difficulties in diagnosis and in a justifiable therapeutic approach. This series reviews the clinical and pathologic features of fibroblastic soft tissue lesions from 66 children. Although radical procedures were occasionally required to achieve local control of an aggressive lesion, conservative surgery was generally successful. Recurrences were frequent, but only one lesion, in an adolescent, metastasized. No prognostic value could be found in anatomic location or in histologic features. Even cellular lesions with frequent mitoses ordinarily did not require the aggressive therapy needed in similar lesions in adults. In this series, incomplete original excision was frequent and usually related to the infiltrating margins of the lesion.