Air-leak syndrome (ALS) is an independent poor prognosis factor among adult patients who have received hematopoietic stem cell transplantation (HSCT), which 5-year overall survival (OS) is less than 30%. However, the clinical features of ALS among post-transplant pediatric patients have rarely been explored.We retrospectively reviewed 2,206 pediatric patients who received an allo-HSCT between January 2013 and December 2019 at the Hebei Yanda Lu Daopei Hospital and analyzed the role of ALS in their prognosis following HSCT.We divided ALS into two categories: 15 cases of bronchiolitis obliterans syndrome (BOS) and 13 cases of idiopathic pneumonia syndrome (IPS).Following treatment of the ALS, 18 patients survived (18/28, 64.3%) and 10 patients died of respiratory failure or infection (10/28, 35.7%). The OS of ALS in our hospital is significantly higher than that cited in previous reports which may be related to early diagnosis and timely FAM treatment.