BACKGROUND: While diagnosis of ganglion cysts of the wrist in the pediatric population is common, data on management are limited. This study describes a nationwide analysis of the incidence and treatment of pediatric ganglion cysts. METHODS: Patients who were diagnosed with a wrist ganglion cyst were identified from the PearlDiver database. Exclusion criteria included age over 18 years, incidence of different cyst diagnosis codes, fewer than 6 months of records prior to first diagnosis, and fewer than 2 years of follow-up. The use of imaging and common treatments for ganglion cysts including bracing, aspiration/injection, and surgery were noted. Patients were followed for 2 years, and factors associated with undergoing surgery were analyzed. Trends in the diagnosis and surgical management of ganglion cysts by age were observed. RESULTS: A total of 33 884 patients with a ganglion cyst on the wrist were identified. Diagnoses increased exponentially with age, while the percentage of patients who underwent surgery increased linearly with age. Those who underwent surgery tended to be older and were more likely to be female. These patients were also more likely to have undergone ultrasound or magnetic resonance imaging. There was a statistically significant difference in prior use of nonoperative management between patients that did and did not undergo surgery. CONCLUSION: This study offers a nationwide analysis of pediatric ganglion cysts. These findings are important to consider during longitudinal patient counseling and surgical planning.