Craniopharyngioma is a rare benign pituitary tumour that occurs in children and adults. Recurrence rates are high (up to 90%) but factors underpinning this are unclear, particularly in cases of childhood onset. We aimed to investigate factors that may influence subsequent recurrence rates in childhood onset craniopharyngiomas in patients attending our centre. A retrospective study of patients followed up at the Oxford Late Effects of Childhood Cancer service was conducted. Patient records were studied and information on clinical variables, the primary tumour and recurrence extracted. Patients were grouped according to their surgical treatment (subtotal resection, transsphenoidal aspiration or fenestration), radiotherapy modality and dosimetry and radiotherapy fractions as well as subsequent growth hormone replacement therapy, tumour histology and post-surgical endocrinopathies. Fishers exact test was used to analyse recurrence rates. Twenty one patients were identified who had been followed up for up to 31 years (median of 15 years). This patient population was characterised across a range of variables. Notably, all tumours had adaminitomous histology, and all patients suffered from panhypopituitism post-surgery. There was a trend towards improved outcome with combined surgery and radiotherapy compared to surgery alone but this did not reach robust levels of statistical significance (P=0.101). No statistically significant association was found between any of the surgical treatments and recurrence rates (P=0.595). Furthermore, no statistically significant association was found between growth hormone replacement therapy and recurrence rates (P=0.100). This is one of the largest single centre reports on childhood onset craniopharyngiomas from the UK. Our data again demonstrate that Growth Hormone therapy is safe in this patient population. Factors influencing recurrence rates in childhood onset craniopharyngiomas are elusive, though further work constructing a multi-centre population could show effects which this is not powered to demonstrate. Understanding craniopharyngioma recurrence is vital to improve treatment decisions and patient quality of life.