Littoral cell angioma (LCA) is a rare primary splenic vascular tumor, originating from the littoral cells lining the red pulp sinuses of the spleen. There are only a handful of case reports of LCA in children to be found in the literature. We performed a retrospective analysis of the medical charts of pediatric patients with splenic lesions who were treated between 2005 and 2010 in the Pediatric Surgery Department of the Medical University of Bialystok. Surprisingly, LCA accounted for 37.5% of the splenic lesions found in our series. The majority of LCA tumors are benign, but given their malignant potential, splenectomy and long-term follow-up should be the gold standard for their management. We strongly support the use of further cross-sectional studies to properly elucidate the prevalence of littoral cell angioma of the spleen in the pediatric population.