Background: To investigate the safety, feasibility, and complications of using duodenum-preserving pancreas head resection (DPPHR) to treat pediatric benign and low-grade malignant pancreatic head tumors. Methods: Patients with pancreatic head tumors that underwent resection were retrospectively analyzed for perioperative factors and postoperative complications. Results: Thirty-five patients with a median age of 10 years at diagnosis were identified. Patients were divided by procedures into the DPPHR (n = 22), local enucleation (n = 7) and pylorus-preserving pancreatoduodenectomy (PPPD, n = 6) groups. No significant difference was found in operation time between the DPPHR and PPPD groups (P > 0.05). Significantly, longer drainage time, duration of somatostatin use and hospital stay were observed in the DPPHR group than in the PPPD group (P < 0.05). The incidences of short-term complications were not significantly different among the three groups (P > 0.05). The incidence of long-term complications was markedly lower in both the DPPHR and local enucleation groups than in the PPPD group (P < 0.05). Conclusion: DPPHR might be a safe treatment option for pediatric patients with benign and low-grade malignant pancreatic head tumors. The incidence of long-term complications was significantly lower with DPPHR. However, perioperative management might be challenging for surgeons. © 2019