Thyroid and adrenal tumors, excluding neuroblastoma, are infrequent in children. Because of the problems involved in applying diagnostic and prognostic criteria developed for adult tumors to pediatric tumors, proper diagnosis of thyroid and adrenal tumors in pediatric patients and proper patient management require close collaboration on the part of clinicians, surgeons, and surgical pathologists. In view of that fact, an approach to handling thyroid and adrenal tumors is presented. Special attention is paid to the following aspects of managing both types of tumors: procedure, fine-needle aspiration, intraoperative consultation (frozen sections), gross examination, histologic examination, special studies, diagnosis, and prognostic features.