Parathyroid gland (PG) auto-transplantation is performed to preserve the function of de-vascularized or unintentionally removed PGs, however, little has been published about the technique and outcomes in children. In our study, we aimed to present the results of PG auto-transplantation in children undergoing thyroidectomy or parathyroidectomy at a tertiary single institution. A retrospective review identified 14 patients (<
18 years of age) who underwent PG auto-transplantation from January 2000 to December 2022. 57.1% (8/14) had transient postoperative hypocalcemia and 14.3% (2/14) had permanent postoperative hypocalcemia. Eight patients had transient hypoparathyroidism, correlating with the rate of transient hypocalcemia. The most common reimplantation site was the sternocleidomastoid (11/14) and it was significantly associated with normalized calcium levels 6 months after auto-transplantation (p=0.033). Bilateral central neck dissection and surgical indication of cancer had a statistically significant association with transient hypocalcemia (p=0.03 and p=0.005, respectively). Our study provides valuable insights into the outcomes of PG auto-transplantation in pediatric patients, highlighting the potential for successful engraftment and factors associated with hypocalcemia.