In this review the clinical features, operative procedure and outcome of surgery in 15 children with oesophageal hiatus hernia is presented. The commonest type was the sliding hiatus hernia. The main presenting clinical features included repeated vomiting, anaemia and malnutrition. At surgery, either an abdominal or a thoracic approach was used. The abdominal approach was found to be less traumatic and easier than the thoracic one. Postoperatively, gastro-oesophageal reflux (GOR) was found to be a common early complication in cases treated with simple repair of the hiatus plus fixation of the stomach to the diaphragm. Repair plus Nissen operation prevented GOR and was found to give the best results.