PURPOSE: Regional lymphadenitis is the most common complication of BCG vaccination and has various clinical course and prognosis, but there are no accurate guidelines for the management BCG lymphadenitis. This study was performed to reveal the clinical course of BCG lymphadenitis and provide guidelines for its management by comparison of observation and medication groups. METHODS: Between January, 2002 and April, 2003, 45 patients with non-suppurative lymphadenitis were reviewed. They were divided into two groups, and retrospectively compared. Group I consisted of 25 observation cases and group II of 20 antituberculous medication cases. RESULTS: The most prevalent age group of the 45 cases was three months old, and the most prevalent site of lesion was the ipsilateral axilla. A palpable single lesion was the most common finding. According to treatment (observation vs. antituberculous medication), the medication did not affect the prevention of suppuration. CONCLUSION: For the management of BCG lymphadenitis, systemic antituberculous medication and observation are not recommended, with active surgical resection being the treatment of choice.