OBJECTIVE: To retrospectively analyze the methods of pacemaker installation in infants and children, their characteristics, and the management of related complications at follow-up. METHODS: For infants and children who underwent pacemaker installation in our hospital between April 2000 and December 2011, endocardial and epicardial pacing were selected according to the etiology, age, and weight. All children with post-surgical AV block were paced with epicardial pacing; they were discharged after 5 days of antibiotic treatment after pacemaker installation. At follow-up, electrocardiogram, chest X-ray, and cardiac ultrasound were performed, and pacemakers were programmed. Results: There were 46 cases, 29 males and 17 females, mean age 1.57±0.89 years (0.4-3.5 years), mean weight 10.93±3.34 Kg (5.6-18 Kg), endocardial pacing in 17 cases, epicardial pacing in 29 cases, single-chamber pacing in 45 cases, double-chamber pacing in 1 case, combined atrial septal defect in 2 cases, combined arteriovenous catheterization in 2 cases. The pacemakers were installed after intervention in 2 cases and 2 cases with combined atrial septal defect; 30 cases were followed up for an average of 4.86 years (1-10 years), 13 cases had their pacemakers replaced due to battery depletion, 7 cases had their leads replaced due to lead displacement or dislodgement; 1 case of complete transposition of the great arteries/ventricular septal defect had its lead removed 21 days after surgery to restore atrioventricular conduction, 2 cases had wound infection and dehiscence at 1 and 3 months after surgery, and 1 case Three cases of epicardial pacing were replaced with intracardiac dual-chamber pacing, and three cases of endocardial pacing were changed from single-chamber pacing to dual-chamber pacing. Conclusion: Pacemaker installation in infants and children is safe, effective, and with few complications. Endocardial or epicardial pacing should be selected according to the specific conditions of the child, and complications such as infection, lead displacement, dislodgement, and premature depletion of the pacing battery should be noted at follow-up.