Objective To examine the diagnosis, surgical treatment, and treatment outcome for sellar tumors in children.Methods The clinical data of 170 children with sellar tumors in our hospital from January 2014 to May 2017 were reviewed. Surgical approach was selected based on the patients' tumor location and size. Of the 170 patients, 30 were treated via the pterional approach, 90 were treated via the subfrontal approach, 30 were treated via the corpus callosum approach, and 20 were treated via the subfrontal and corpus callosum approach. Postoperative pathological examination revealed 90 cases of craniopharyngeal tumor, 45 cases of germ cell tumor, 25 cases of optic nerve glioma, 8 cases of pituitary adenoma, and 7 cases of hypothalamic hamartoma.Results Among the 170 children, 132 had total resection, 23 had subtotal resection, 15 had partial resection, and 4 died after surgery. All patients were followed up for 3 months to 3 years. Furthermore, 52 patients received postoperative radiotherapy and chemotherapy, 25 had recurrent tumor, and 10 underwent secondary operation.Conclusions The selection of surgical approach based on tumor location and size and improvement of total resection rate are key steps in the treatment of sellar tumors in children. Postoperative radiotherapy and chemotherapy are also very important.