The treatment of gill slit cysts in children depends on the degree of infection, with surgery being relatively less difficult in the absence of infection and more difficult in the presence of infection. Gill slit cysts are congenital malformations that occur when the gill slits fail to degenerate completely, inducing the appearance of fistulas that continue to secrete fluid outward. Surgical treatment is necessary because medication is generally ineffective. In children without infection, the fistula inside the cyst is clearly structured, and radical surgery is relatively simple and less risky, making it easier to treat. However, in children with varying degrees of infection in the cyst, the fistula structure is disrupted, which makes surgery more difficult and increases the risk of infection later in life. Therefore, the infection needs to be stabilized before surgery, and all the lesions need to be removed during surgery. At the same time, if the rupture of the capsule wall is found during surgery, the capsule wall should be cut cleanly as much as possible, and the surrounding fascial connective tissue should be completely removed to avoid recurrence.