Key PointsQuestionIs there a survival benefit associated with liver transplant vs resection in pediatric patients with hepatoblastoma receiving chemotherapy?FindingsIn this cohort study of 443 pediatric patients with hepatoblastoma, 93 were treated with liver transplant, with increasing proportional use from 1998 to 2016. Compared with patients undergoing liver resection, liver transplant was not associated with improved overall survival among pediatric patients receiving chemotherapy.MeaningThis study suggests that liver transplant is not significantly associated with improved overall survival compared with liver resection combined with current chemotherapy regimens in pediatric patients with hepatoblastoma.