Five children with constrictive pericarditis are described. All underwent surgery to release the restricted heart, and two died. Tuberculosis still plays a major role in the aetiology of this disease; it was proven in one patient and suspected in two others. No other aetiological factors were identified. Clinically, constrictive pericarditis does not differ from the disease described in adults. Protein-losing enteropathy as a result of the constricted pericardium was present in the youngest patient in this series. The degenerative changes taking place in the myocardium, secondary to the pericardial involvement, mainly determine the outcome of surgery. Pericardiectomy and decortication of the constricted pericardium should be performed without delay, as soon as this diagnosis is established.