Background Congenital lung anomalies pose a challenge for not only the pediatric surgeons but also for the treating physicians. Controversy exists regarding the diagnosis and the management of the cases. Objective: The aim of this study was to highlight the difficulty in diagnosis of congenital lesions of lung in children, and to create awareness among the physicians regarding avoiding the use of antitubercular treatment (ATT) and intercostal drainage (ICD) in managing these surgical conditions. Methodology: Retrospective analysis of records of all the children diagnosed with congenital lesion of lung and treated in our department from January 2005 to December 2018. Informed consent from the parents taken at the time of admission. Inclusion criteria included cases which received either ATT or ICD before being referred to our institute. Investigations include X -ray, and Contrast enhanced tomography (CECT) chest. Results: A total of 27 cases of congenital lesions of lung were operated between Jan 2005 to Dec 2018. Out of these 27, 13 (48.1%) received either ATT or ICD and formed our study group. Out of these 13, 8(61.5%) received ATT, while 5 (38.5%) received ICD as initial management before being referred to us. There were 19 (70.3%) male and 8(29.7%) females. The most common lesion was CCAM seen in 6 (46.1%) followed by CLE 4(30.7%), BPS in 2 (15.3%) and Bronchogenic cyst 1(7.6%). Conclusion: cystic lesions of lung in children should be investigated thoroughly and ATT should not be started empirically. Pneumothorax should be differentiated from other emphysematous/ cystic lesions before submitting the child for intercostals drainage. Keywords: Cystic lesions of lung, anti-tubercular, pneumothorax, emphysema, intercostal drainage.