To evaluate the efficiency of laser thermocoagulation under computed tomography (CT) guidance in the treatment of osteoid osteoma within a strictly pediatric group. Twenty-five patients aged 4 to 17 years were treated under CT by laser thermocoagulation. The nidus measured on average 10.1 mm. Pain relief was the main item for evaluation of the effectiveness of our treatment. Follow-up ranged from 3 months to 61 months (mean, 26 months). Technical success was achieved in 100%. Thermocoagulation proved to be initially effective in 24 of 25 children (96%) and had a positive long-term effect in 23 of 25 children (92%). We had four minor complications and one severe complication (partial osteonecrosis of the talus). Laser thermocoagualation is an effective treatment for osteoid osteoma in pediatric patients.