Abstract: Objective To investigate the clinical effect and safety of one-stage transanal Soave pull-through procedure (modified Soave procedure) and radical operation via abdominal and perineal approach in the treatment of congenital megacolon (Hirschsprung's disease). Methods The clinical data of 52 children with Hirschsprung's disease in our hospital from October, 2014 to August, 2017 were reviewed. The patients were randomly divided into observation group and control group with 26 cases in each group. The control group underwent the radical operation via abdominal and perineal approach, while the observation group received the modified Soave procedure. The operation time, the amount of bleeding in the operation, the recovery time of gastrointestinal function and the time of hospitalization were compared between the two groups. The postoperative defecation and complications were compared between the two groups. The children were followed up 6 months after the operation to evaluate their quality of life and parents' satisfaction. Results The operative time, intraoperative blood loss, gastrointestinal function recovery time and hospitalization time in the observation group were significantly shorter than those in the control group, the differences were statistically significant (P<0.05). The postoperative defecation and complications of the children in the observation group were significantly better than those in the control group, and the difference was statistically significant (P<0.05). The quality of life and the satisfaction of the parents in the 6 months of the observation group were significantly better than those in the control group, and the difference was statistically significant (P<0.05). Conclusion For the treatment of congenital megacolon, the modified Soave procedure is our preferences. When compared with the radical operation via abdominal and perineal approach, the children with modified Soave procedure will have good postoperative recovery, the improved quality of life, and the higher satisfaction of parents. It is worthy of extensive popularization and application.