Objective: The erector spinae plane block (ESPB) was first described in 2016. Recently the use of ESPB at the sacral levels was defined for adult surgeries, and a modification of the technique for pediatric surgeries, with the claim that it could replace caudal blocks, was described by our clinic. Methods: This retrospective cohort study was approved by the institutional ethical committee of Kocaeli University Hospital (GOKAEK-2021/6.04). The data were obtained from the registry of regional anesthesia saved in the department. Pre- and perioperative data regarding age, height, weight, American Society of Anesthesiologist classification, surgery duration, and anesthesia duration during the perioperative period were collected. US-guided S-ESPB was successfully applied to 16 patients included in the retrospective study. The registry of regional anesthesia data includes detailed information on block performance, postoperative pain severity, and complications in the early postoperative period (for at least 24 h). Results: 16 pediatric patients were included in the retrospective study. The mean age of the patients was 21,5 months. The mean weight of the patients was 13,1kg. In the postoperative 24-hour follow-up, one patient had a The Face, Legs, Activity, Cry, Consolability (FLACC) score greater than 4 in the PACU. None of the patients were observed to have postoperative complications. Conclusions: To our knowledge, this study is the first to retrospectively investigate the efficacy of the S-ESPB in pain management in pediatric patients. The sacral ESPB appears to be an effective option for postoperative pain in pediatric patients undergoing lower abdominal surgery.