Objective: To assess the incidence and nature of perioperative complications in pediatric anesthesia at the University Hospital Center (CHU) of Conakry. Material and Methods: This was a prospective, descriptive study conducted over a period of eight (8) months, from June 1, 2024, to January 31, 2025, at the CHU of Conakry. Included were children under 18 years of age who underwent elective or emergency surgical procedures and experienced intraoperative or postoperative complications within 15 days of surgery, with obtained consent. Results: Out of 452 surgical procedures, 124 intraoperative complications (27.4%) and 176 postoperative complications (38.9%) were recorded. The mean age of the children was 6 ± 5 years, with the majority classified as ASA I (71.68%) and a sex ratio of 1.22. Visceral surgery was the most common (79.65%), followed by orthopedics (10.62%), neurosurgery (4.42%), otolaryngology and urology (2.66% each). Procedures were elective in 65.5% of cases. Appendicitis (25.66%), peritonitis (16.81%), and intestinal obstruction (9.73%) were the main indications. The most frequent complications were infectious (45.65%), hemorrhagic (36.96%), and cardiovascular (17.39%). Conclusion: This study highlights the need to improve perioperative safety in pediatric anesthesia, particularly in resource-limited countries. Optimizing anesthetic and surgical practices is essential to reduce pediatric morbidity and mortality and to improve postoperative outcomes.