We report on the rare disease of posterior fossa abscesses secondary to dermal sinus associated with dermoid cyst in 4 pediatric cases seen over a 15-year of period. All children had a small dimple or a pinhole on the skin of the occipital region. On admission they had the signs of increased intracranial pressure, while 3 of them still suffered from signs of meningitis resulting from a bacterial infection through the dermal sinus. CT scan and MR images revealed both the route of the dermal sinus and intracranial lesions. Total resection was successfully achieved before various treatments in all patients without nervous sequelae. In conclusion, a posterior fossa dermoid cyst should be considered in all children with an occipital dermal sinus. Cerebellar abscesses will arise once bacterial infection has occurred through the associated dermal sinus. Radiological studies such as CT scans and MR images can help confirm the diagnosis and locate the lesions. Early neurosurgical interventions including external ventricular drainage, external abscess drainage and primary removal should be planned as soon as possible in accord with the children's condition.