Arteriovenous malformations (AVM) are an important cause of stroke in children, the majority being discovered at the time of bleeding. Unruptured AVM (URAVM) are much less common, although these malformations are increasingly recognized as fortuitous findings [1]. The prevalence of URAVM is estimated at 0.05% of patients undergoing an MRI [2]. However, the data from the literature regarding the outcome of URAVM in children, treated or not treated, are scarce. Active management of URAVM has been questioned since the publication of the ARUBA trial, which concluded “medical management alone remained superior to interventional therapy” [3]. However, the ARUBA study enrolled only adults, and transposing its conclusions to children may be questionable. In the absence of a randomized trial in pediatric URAVM, the rationale for decision-making in children is unclear. The authors of the ARUBA study also noted: “The even longer-term risks and differences between the two therapeutic approaches [i.e. abstention and active treatment] remains uncertain” [3]. Since very-long-term outcome is the outstanding concern of all specialists dealing with children, this caveat understates the fears of all parents their caregivers. Unfortunately, the data regarding URAVM in children, in particular their natural history as well as outcome after treatment, are scarce in the literature. We decided to review retrospectively our experience with URAVM in children, untreated or treated according to different protocols, and study the results regarding the obliteration of the AVM and clinical outcome.