Objective <p>To investigate the efficacy and safety of ultrasound-guided hydrostatic enema reduction in treating recurrent intussusception in children.</p> Methods <p>Medical records of patients with recurrent intussusception treated by ultrasound-guided hydrostatic enema reduction at Wuhan Children’s Hospital from July 2019 to May 2024 were retrospectively analyzed. Patient gender, age, recurrence frequency, and reduction success rates were observed.</p> Results <p>From July 2019 to May 2024, a total of 3,084 children underwent ultrasound-guided hydrostatic reduction at Wuhan Children’s Hospital. Of these, 2,961 cases achieved successful reduction (success rate: 96.0%) and 123 cases experienced reduction failure (failure rate: 4.0%). During hospitalization, 215 patients developed recurrence (recurrence rate: 7.3%). These 215 patients with recurrence were enrolled in the present study, including 156 males and 59 females, aged 0.59–10.42 years (mean 3.04 years). The number of recurrences during hospitalization ranged from 1 to 9 times (average 1.73 times). The distribution of recurrence frequency was as follows: 143 patients (66.5%) experienced 1 recurrences, 32 patients (14.9%) had 2 recurrences, 19 patients (8.8%) had 3 recurrences, and 21 patients (9.8%) had 4 or more recurrences. All patients underwent successful ultrasound-guided hydrostatic enema reduction without significant secondary factors identified, and none required surgical exploration.</p> Conclusion <p>Ultrasound-guided hydrostatic enema reduction is safe and effective for recurrent intussusception in children. In the absence of obvious secondary factors, enema reduction may be considered as a preferred first-line treatment for recurrent intussusception to avoid unnecessary surgical exploration.</p>