Background. Management of the patients with urachal remnants (URs) has been under discussion for a long time. The traditional approach with surgical removal of all urachal remnants, has been changed to a more conservative, which is preferred by many surgeons, especially in asymptomatic patients.
Aim. The purpose of this study was to optimize the treatment of patients with URs, primarily for asymptomatic children.
Results. Our previous screening study showed that real incidence of the URs in childhood is significantly higher than it was previously stated. Based on our data and the results of literature review, we propose an algorithm for the workup and treatment of children with URs.
Conclusion. We assume that the risk of developing complications (primarily, malignancy) was previously significantly overestimated. In this regard, we recommend conservative tactics in in most asymptomatic cases.

Keywords: pediatric surgery, urachus, laparoscopy, management, children