Objective: To compare the outcomes of sclerotherapy with bleomycin versus surgical resection in children with cystic hygroma. Study Design: Comparative/Observational Place and Duration: Paediatric department of Khalifa Gul Nawaz Medical Teaching Institute, Bannu for 20 months duration from 1st August 2019 to 31st March 2021. Methods: Total 40 patients of both genders with ages 1 month to 15 years presented with cystic hygroma were included in this study. Patients' detailed demographics were recorded after written consent from parents/guardians. Patients were divided in to two groups’ i.e. Group A consist of 20 patients and received sclerotherapy with intra-lesional bleomycin and Group B consist of 20 patients received surgical excision. Outcomes were analyzed at post-procedure 3 and 6 months post-procedure and compared the findings between both groups. Results: There was no significant difference observed between both groups regarding age, gender and site of lymphangioma p-value >0.05. In Group A 15 (75%) patients showed excellent results, 3 (15%) patients showed good results and 2 (10%) showed poor results. In Group B 13 (65%) showed excellent results, 4 (20%) showed good results and 3 (15%) showed poor results. At final follow-up there were no patient with recurrence in Group A while in Group B 2 (10%) patients had recurrence, Conclusion: It is concluded that sclerosing treatment with bleomycin is a safe and effective treatment modality with no recurrence as compared to surgical rexection. Keywords: Cystic Hygroma, Sclerotherapy, Bleomycin, Surgery, Recurrence