Objective To evaluate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) for diagnosis and treatment of pancreas divisum （PD） combined with chronic pancreatitis (CP) in children. Methods Data of patients under 18 years old diagnosed as having PD with CP in Hangzhou First People's Hospital from January 2010 to January 2020 were retrospectively analyzed. The general information, endoscopic procedures and follow-up of the children were recored. The number of acute pancreatitis attacks, visual analogue scale (VAS) scores of the abdominal pain, and the diameter of pancreatic duct before and after ERCP were compared. Results A total of 19 children diagnosed as having PD with CP underwent 82 ERCP procedures with the mean number of 4.31 (1-9). The mean number of pancreatic stent replacement was 3.21 (0-8). The success rate of minor papilla cannulation was 97.6% (80/82) with the pain relief rate of 89.5% (17/19) after the first ERCP. ERCP-related complication rate was 4.9% （4/82）without transference to surgery. The mean follow-up time was 55.8 months （9-114 months）. The median number of acute pancreatitis attacks decreased from 3.0 to 0 compared with that before the procedure （Z=-3.839, P<0.001） and the median VAS score decreased from 6 to 1 （Z=-3.748， P<0.001）, both of which had significant difference. However, the median diameters of main pancreatic duct were both 0.35 cm before and after procedure with no significant difference (Z=-0.699, P=0.484). Conclusion ERCP is safe and effective to diagnose and treat pediatric patients with PD with CP.