Objective To explore the clinical features of children's head shotgun injury at long distance by pellet and its neurosurgical treatment. Methods The clinical data of 12 children with skull shotgun wounds by pellet at distance， who were consecutively admitted in our hospital from January 2000 to January 2017 were retrospectively analyzed. The differences between children's head shotgun injury and general firearm injury in adults were studied. The neurosurgical treatment of children's head shotgun injury at long distance by pellet was summarized. Results There were three cases of local debridement， seven cases of craniotomy， two cases of stereotactic surgery and one case of re-craniotomy for the metal foreign bodies. There were six cases of metal foreign body residues after operation， two cases of postoperative infection， one case of postoperative epilepsy and one case of permanent neurological dysfunction. Conclusions Children's head shotgun injury at distance seems to have a better outcome compared to adults gunshot wounds， with considerable postoperative longterm effects. A relatively conservative debridement is suggested for this kind of gunshot injury， so as to avoid aggravating neurological damage. There is no significant increase in the incidence of postoperative infection and epilepsy with the presence of residual metal in the cerebral.