Abstract Background Limited data is available regarding topical and systemic therapies for Leishmania tropica in children. Objective To characterize the clinical presentation and evaluate the efficacy and safety of topical and systemic treatments in pediatric patients infected with L. tropica. Methods A retrospective study was performed on 47 children with L. tropica CL. Treatments included topical or systemic therapy with liposomal amphotericin B (L-Amb) or pentavalent antimony. Results Seventy patients with L. tropica CL were treated at our center between 2008 and 2012, of which 47 (67%) were children. The average age of the pediatric population was 8.8 years, and the face was the most common site of involvement (76%). The average number of lesions was 2.6 twenty four children (51%) required systemic therapy. The patients were treated with 3–5 mg/kg/day intravenous (IV) L-AMB, and a response was observed in 83% of the patients within 3 months. Limitations A retrospective study Conclusion The disease burden of L. tropica in children is high, and because of facial involvement and a low response to topical therapies, systemic therapy is often required. In our experience, L-AMB treatment in children is safe and effective and is required for a considerably shorter duration than treatment with pentavalent antimony.