The Nissen fundoplication is the operative therapy of choice in children with symptomatic gastro-esophageal reflux. In recent years several reports on specific complications of the Nissen fundoplication have been published. This report summarizes the complications in 45 patients on whom a Nissen fundoplication was performed in our clinic between 1979 and 1989. 18 patients (40 %) showed early or late complications. In 10 patients (22 %) reoperation was necessary. However, at follow-up with a mean period of 41/2 years after surgery, 36 patients (92 %) showed good results without any residual symptoms. The Nissen fundoplication had in our hands a rather high rate of complications. However, late results were excellent and our healing rate (92 %) was higher than reported in other series with different techniques.