The recent more widespread availability of cultured keratinocytes has increased their clinical applicability in pediatric surgical problems. In life threatening burns (3 patients) and in elective procedures (3 patients) we have used sheets of cultured epithelial autografts. Body surface area affected ranged from fifteen to 85%. Five patients were successfully treated in one grafting session and one required four sessions. Take of the cultured keratinocytes ranged from 75% to 95%. Follow-up as long as 30 months has shown the skin to be comparable to if not superior to conventional split thickness grafts. The use of cultured keratinocytes allows wound coverage without expansion of the affected body surface area seen with conventional split-thickness skin grafting. Although there is an initial delay in the preparation of the grafts, the overall results have been excellent and suggest the more frequent use of this method.