Abstract Purpose: The aim of this study was to compare the clinical outcomes of four surgical procedures to treat Hirschsprung’s disease (HD) in children. Materials and methods: One hundred thirty-eight children with HD were included in this retrospective study. The children underwent four types of pull-through procedures between 2015 and 2020. Sixty-one (44%) children were older than 3 years of age at the time of surgery. In this study, we evaluated the functional outcome by measuring the incidence of postoperative complications. Results: The surgical procedure consisted of 90 transabdominal (modified Soave – n=72; Swenson procedure – n=8; Swenson-like – n=10) and 48 transanal endorectal pull-through (TEPT) procedures. Early postoperative complications were seen in 13 children and consisted of faecal incontinence (5; 3.6%), anastomotic stricture (4; 2.8%), and cuff abscess (2; 1.4%); one child had dysuria and anastomotic dehiscence (0.7%). Nine of these early postoperative complications were after modified Soave pull-through. Episodes of Hirschsprung-associated enterocolitis occurred more often after transabdominal pull-through procedures (14.4% vs 8.3%; p=.04). Conclusion: Children who underwent TEPT had a lower rate of postoperative complications, especially episodes of postoperative Hirschsprung-associated enterocolitis. Therefore, in the treatment of HD in children, preference should be given to TEPT, which is less traumatic, has better cosmetic outcomes and has low incidences of postoperative complications.