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Background: The reconstruction of hepatic artery is a challenging part of the pediatric liver transplan- tation procedure. Hepatic artery thrombosis (HAT) and stenosis are complications which may result in ischemic biliary injury, causing early graft lost and even death.Methods: Two hundred and fifty-nine patients underwent liver transplantation in 2017 in a single liver transplantation group. Among them, 225 patients were living donor liver transplantation (LDLT) and 34 deceased donor liver transplantation (DDLT). Results: In LDLT all reconstructions of hepatic artery were microsurgical, while in DDLT either microsurgi- cal reconstruction or traditional continuous suture technique was done depending on different conditions. There were five (1.9％) HATs: four (4/34, 11.8％) in DDLT (all whole liver grafts) and one (1/225, 0.4％) in LDLT ( P = 0.001). Four HATs were managed conservatively using anticoagulation, and 1 accepted salvage surgery with re-anastomosis. Until now, 3 HAT patients remain in good condition, whereas two devel- oped biliary complications. One of them needed to be re-transplanted, and the other patient died due to biliary complications. Conclusions: Microsurgical technique significantly improves the reconstruction of hepatic artery in pedi- atric liver transplantation. The risk for arterial complications is higher in DDLT. Conservative therapy can achieve good outcome in selected HAT cases.