Objective To investigate the clinical effect of drilling combined with urokinase lavage in the treatment of epidural hematoma in children, as well as its feasibility and safety.Methods A retrospective analysis was performed for the clinical data of 53 children with epidural hematoma who underwent drilling combined with urokinase lavage from January 2007 to May 2016, and the treatment outcome and prognosis were observed.Results All children underwent a successful surgery within 12-24 hours after injury, and the mean time of operation was 30 minutes. All children underwent no more than 4 times of urokinase lavage. Head CT showed that epidural hematoma was almost removed, and the symptoms such as headache, dizziness, nausea, and vomiting gradually disappeared. There were no cases of bleeding, conversion to craniotomy, infection, or death. All patients had good recovery of intelligence, memory, and language; 2 children had mild limb activity disorder and 1 child had secondary epilepsy. The children were followed up for 6-24 months and there was no recurrence of epidural hematoma. The length of hospital stay ranged from 8 to 18 days (mean 12 days).Conclusions Drilling combined with urokinase lavage in the treatment of epidural hematoma in children has the features of small trauma, few complications, low medical expenses, satisfactory effect, and easy acceptance by family members, and therefore, it is an effective and reliable treatment. Strictly following surgical indications and timing and fine intraoperative and postoperative treatment are the key to an effective treatment.