OBJECTIVES: To assess the impact that serious post-operative infections (SPOI) have on hospitalization outcomes (i.e., resource utilization, length of stay, and inpatient mortality) in pediatric patients undergoing brain tumor resection. METHODS: Data from the 2003-2012 Nationwide Inpatient Samples (United States Agency for Healthcare Research & Quality) were analyzed for this study. Patients aged 20 and younger were eligible for inclusion if they had a malignant brain tumor (ICD-9 diagnosis codes 191.xx and/or 198.3) and underwent tumor resection (ICD-9 procedure code 01.59) during hospitalization. SPOI, including bacteremia (ICD-9 diagnosis code 790.7), septicemia (ICD-9 diagnosis code 038), pneumonia (ICD-9 diagnosis codes 481, 482, 483, 485, or 486), and wound infections (ICD-9 diagnosis codes 998.51 and/or 998.59) were also identified in the discharge summary. The impact of the serious SPOI on hospitalization outcomes were then assessed using bivariate and multivariate models. RESULTS: A total of 7,845 pediatric patients underwent brain tumor resection (Median Age: 8 years [IQR: 3-15]. Of these patients, 5.9% (N=461) had a SPOI, of which septicemia/bacteremia was the most common (N=312). SPOIs increased the odds of inpatient death nearly four-fold (unadjusted OR: 3.76 [2.62-5.40], p<.0001). When adjusted for patient characteristics, SPOIs were still associated with a nearly four-fold increase in the odds of inpatient mortality (adjusted OR: 3.73 [2.59-5.36]). Patients with SPOIs stayed significantly longer in the hospital (Median: 16 days [IQR: 6-33]) than those without SPOIs (Median: 5 days [IQR: 3-10]) (p<.0001). On average, patients with SPOIs underwent four additional procedures during the hospitalization stay (Median: 6 procedures [IQR: 2-8]) than those without SPOIs (Median: 2 procedures [IQR: 1-5]) (p<.0001). CONCLUSIONS: SPOIs significantly increase resource utilization, length of stay, and odds of inpatient mortality for pediatric patients undergoing brain tumor resection. Quality and process improvement efforts should be considered to minimize the risk of SPOIs in this patient population.