Four patients (two boys and two girls, 6 to 13 years of age) with the Guillain-Barré syndrome (GBS) exhibiting such pronounced symptoms as dyspnea and dysphagia were treated with plasmapheresis using an intermittent flow system or double filtration plasmapheresis. The duration of the disease before plasmapheresis varied between 4 and 11 days. Three of the four patients experienced marked improvement during the course of plasmapheresis, but one patient had only partial improvement. No serious complications occurred. Good clinical and electrophysiologic recovery enjoyed by most patients treated with plasmapheresis appears to confirm the efficacy of plasmapheresis in children with severe GBS.