PURPOSE: Pneumatic reduction has rapidly replaced traditional barium reduction owing to its potential advantages, such as higher reduction rate and greater safety; however, the effects on surgery after reduction failure have not been studied. In this study, we evaluated the influences of attempted barium and pneumatic reductions on subsequent surgical procedures. METHODS: One hundred and sixty-one barium reductions were performed on 158 patients while 153 pneumatic reductions were performed on 145 patients. Statistical comparisons of these two reduction methods were made regarding the following variables: the reduction rates, frequencies of bowel perforations and recurrences, mean operation times, fasting periods, and durations of admission. RESULTS: The reduction rates were similar for both groups with barium reduction being successful in 67.1% of the cases (108/161) and pneumatic reduction in 69.3% (106/153). Two cases of bowel perforation occurred during the pneumatic reductions, none were noted during the barium reductions. Recurrence of intussusception was noted in three cases initially reduced with barium and in nine cases reduced pneumatically. The mean operation time (130.7 minutes vs. 81.7 minutes), postoperative fasting time (61.6 hours vs. 37.6 hours), and duration of admission (6.7 days vs. 5.4 days) were significantly prolonged in the pneumatic reduction group. CONCLUSION: A part from a comparable reduction rate pneumatic reduction demonstrated no favorable outcome relative to barium reduction. Furthermore, it resulted in some obstacles to surgery and recovery, such as prolonged operation time, fasting period, and duration of admission.