Massive gastrointestinal bleeding is a disease entity which is more likely to need emergent managements in pediatric patients rather than in adult patients. Eleven cases were reviewed and analyzed clinically. Melena was a principal presenting symptom in all cases. The most common underlying disease was peptic ulcer and the others were chronic inflammatory bowel diseases, Meckels diverticulitis, hemangioma of small bowel and erosive gastritis. The amount of blood loss was estimated by using total blood volume of patients and volume of transfused blood. The main-stay of treatment was prompt surgical intervention after early detection of bleeding site.