Objective: To evaluate the efficacy of chemotherapy combined with125I seed implantation in treating pediatric head and neck soft tissue sarcomas. Methods: The clinical characteristics, overall survival rate, local control rate and event free survival rate of patients treated with chemotherapy and125I seed implantation were studied retrospectively. Results: There were 12 males and 2 female patients. Age at diagnosis ranged between 1.0-10.7 years, and the median age is 4.9 years. Only 3 of the patients had localized disease, the other 11 patients had metastatic disease. The follow up time ranged from 8 to 30.5 months, median follow up time was 12.3 months. The overall response rate (complete response, very good patial response and partial response; CR, VGPR and PR) for all 14 patients was 85%, including 6/14 patients with CR, 1/14 patient with VGPR, 5/14 patients with PR. 2/14 patients had progressive disease. The overall local control rate was 85%, with a median LC time 18.9 months (95% CI: 16.4 to 21.3 month). The overall survival rate in this group of patients was 100%. The overall survival time was 8 to 30.5 months. The event free survival rate was 85%, with a median EFS time 18.9 months (95% CI: 16.4 to 21.3 months). Hematological toxicity was the most common side effects of chemotherapy. 7 of 14 patients suffered from grade 1 or 2 skin reaction after seed implantation. Conclusions: Chemotherapy combined with125I seed implantation is a feasible treatment for children with head and neck sarcomas, with high local control rates and event free survival. © 2016, E-Century Publishing Corporation. All rights reserved.