Frostbite injury in prepubescent children is rare and, as such, has limited research and guidelines specific to managing this population. Here, we present a five patient case series of all prepubescent pediatric patients with severe frostbite injury that were treated with thrombolytics at our ABA verified burn center. All patients were documented to have excellent preservation of tissue with no adverse effects related to thrombolytic administration. This case series underscores the potential of thrombolytic therapy in pediatric frostbite cases, paving the way for improved clinical outcomes and highlighting the necessity of further research to establish standardized treatment guidelines.