OBJECTIVE. We describe a coaxial technique for percutaneous, CT-guided removal of osteoid osteoma in children. SUBJECTS AND METHODS. The study included eight children aged 3 years to 15 years 9 months who had signs and symptoms of osteoid osteoma, The diagnoses were confirmed by CT scans. Seven of nine lesions were removed manually with a coaxial technique and a trephine. Power tools were added to the technique in the other two cases. Removal of the nidus was confirmed by postprocedural CT scans and by histologic examination. RESULTS, All CT-guided excisions were technically successful, and only one minor complication occurred. One recurrence at 13 months was successfully treated percutaneously. CONCLUSION. CT-guided coaxial removal of osteoid osteoma is a safe and effective treatment. Increasing experience and the use of power tools in selected cases helps to shorten the procedure.