Abstract: To analyze the accuracy of the PRETEXT preoperative staging and its value to guide the surgical resection of hepatoblastoma. Methods: Statistical analysis was conducted on data from 40 hepatoblastoma patients younger than 14 years who underwent tumor resection between 1997 and 2008. Preoperative chemotherapy was administered in 32 of the patients. The PRETEXT preoperative staging, modes of surgery, and the results of postoperative pathology were compared to analyze the value of the PRETEXT preoperative staging to guide surgical resection. Results: Of the 40 patients who underwent resection of the primary lesion, 28 had concordance between the PRETEXT staging and histopathology, accounting for 70% of all cases ( 28/40 ). The remaining 12 cases had inconsistencies between the preoperative staging and postoperative histopathology, in which 8 were inappropriately assigned to more advanced stages ( 20%, 8/40 ), and 4 were inappropriately assigned to less advanced stages ( 10%, 4/40 ). Conclusion: PRETEXT preoperative staging provides a basis for the preoperative prognosis, and helps in evaluating whether surgery should be conducted in patients.