Adverse transfusion reactions (ATRs) are unexpected reactions to transfusion. This study examined the frequency, types of ATRs, and related blood products retrospectively in pediatric patients with less information than in adult patients. Four hundred and forty transfusions were performed for two months at a children's hospital: 247 units of red blood cell (RBC) products, 142 units of platelet products, and 41 units of fresh frozen plasma (FFP) were used. Five adverse reactions occurred in five patients, three cases were allergic reactions, and two were febrile nonhemolytic reactions. The frequency was 1.13%, and apheresis platelets and leukocyte-reduced RBC were transfused. Two patients' ATRs were found in the previous transfusions, and ATRs were repeated in subsequent transfusions in one patient. One of the ATRs was not reported to the blood bank and was then discovered during the study. Because pediatric patients may have limitations in recognizing or expressing their symptoms compared to adults, medical staff rely solely on vital signs and laboratory results rather than symptoms, causing difficulty in noticing ATRs. Information on ATRs and education on appropriate blood products will improve awareness of ATRs and blood management among medical staff at transfusion sites and blood banks.