Objective: We sought to evaluate the role and efficacy of intraoperative fistutograms in Visualizing branchial. apparatus (fistula/sinus) abnormalities in the pediatric age group (3 months-12 years).; Methods: This was a retrospective analysis of 20 pediatric patients who underwent fistula and/or sinus excision during a period of 18 years (1988-2006).; Results: The mate:femate ratio was 11:9. Eighteen of the 20 patients presented with unilateral abnormalities, 2 with bilateral abnormalities. An intraoperative fistulogram was utilized in every instance. The fistulogram clearly differentiated the sinus tracts from complete fistulas in all cases. It was also highly useful in delineating the exact length and course of the sinus/fistula tracts.; Conclusions: Intraoperative fistutograms are easy to do in the operating room on the day of the scheduled surgery. They are a very useful tool in the management of branchial apparatus abnormalities. (C) 2008 Elsevier Ireland Ltd. All rights reserved.