The authors review their experience with transrectal drainage of pelvic abscesses in seven children and adolescents (6-16 years old). Initial access was guided by transrectal ultrasound with an endovaginal transducer followed by fluoroscopy for placement of self-retaining catheters (8.5-10 F) using the Seldinger technique. All abscesses were successfully drained without complications. A transrectal catheter was well tolerated by most patients without spontaneous dislodgment. Catheters were removed after an average of 4 days (range 3-7 days). Transrectal drainage of pelvic abscess with transrectal sonographic and fluoroscopic guidance seems to be a safe and effective procedure in children.