Esophageal substitution in children is required in several types of esophageal atresia, as well as following strictures caused by caustic ingestion or peptic esophagitis. Nowadays, two main types of procedures are used for esophageal replacement: colon segment esophagoplasty (that seems to be preferred by most pediatric surgeons) and gastric tube esophagoplasty. The paper presents the personal experience in the management of a series of 56 children with esophageal replacement, during the last 10 years. In 46 patients, the stricture cause was caustic ingestion, while peptic esophagitis accounted for 3 cases. The remaining 7 cases were long-gap esophageal atresias that could not be managed by primary neonatal anastomosis. The results are rated as good in 42 cases. Complications occurred in 13 cases, while fatal outcome occurred in 5 patients. The most remarkable feature of the series is the high number of procedures required after caustic ingestion.