Summary: The aim of the study was to determine the significance of postoperative diaphragmatic paralysis in childhood in both the short and long term. Additionally, the benefits and risks of diaphragmatic plication were to be assessed. During the eleven-year study period, 59 cases of postoperative diaphragmatic paralysis were recorded, corresponding to an incidence of 1.18 percent. In comparison with the control group, there was an increase in morbidity, but not in mortality. Postoperative diaphragmatic paralysis, particularly in younger children, leads to prolonged ventilation time, longer hospital stays, and a higher incidence of ventilation-associated pneumonia. In cases of respiratory insufficiency, diaphragmatic plication has proven to be an effective method for improving pulmonary conditions.