Introduction: English publications have been found to be more widely cited than publications in other languages leading to a higher impact in various fields. Many authors have thus focused on publishing in English so as to reach the largest audience possible, however, important non-English publications remain a vital part of the peer-reviewed literature. This study sought to understand the relative quantities of pediatric orthopaedic publications written in the top 10 languages published in PubMed. Methods: The 10 languages with the most publications in PubMed were analyzed. These included English, German, Chinese, French, Russian, Japanese, Spanish, Polish, Italian, and Portuguese. All publications in orthopaedics and pediatric orthopaedics were pulled for each language. Publication rates were analyzed by individual language and by English versus non-English. Results: A total of 522,099 publications were analyzed between 1960-2020. English publications accounted for 93.1% of all orthopaedic publications and 91.4% of pediatric orthopaedic publications. When analyzing by individual language, German, French, and Chinese accounted for the greatest number of non-English publications with 24.9%, 21.2%, and 20.0% of non-English pediatric orthopaedic publications, respectively. Conclusion: In the 10 languages analyzed in this study, 8.6% of pediatric orthopaedic publications were written in non-English languages. When performing systematic reviews, care should be taken to assess literature published in these languages, specifically German, French, and Chinese, as they account for the greatest number of non-English publications. This will ensure that no relevant constituent studies are missed in qualitative syntheses due to lack of translation or access.