Pediatric occult spina bifida is a congenital malformation that occurs when the spinal canal does not fuse during fetal developmental ossification. There is no optimal time for its treatment, and it needs to be analyzed according to the specific condition. Most children with spina bifida are asymptomatic because the spinal cord membrane and other structures do not protrude beyond the spine, making it difficult to detect the symptoms. This condition does not affect the child and requires no special treatment, but regular review. However, there are a few children with severe back pain, the earlier the child is treated, the better. If the above treatment does not relieve the pain, surgical treatment is required if the child’s circumference is evaluated and the surgery is well tolerated. In conclusion, children with occult spina bifida do not need treatment if they are not in obvious discomfort, but once symptoms appear, the best time to treat them is as soon as possible.