Background: Intussusception is one of most common surgical emergencies in infants and children. Nonsurgical reduction in the currently the standard primary modality for treatment. Air and barium enema reduction are effective but exposure to ionizing radiation is a major drawback. There is a debate among centers so as to which type of reduction is better. Ultrasound guided reduction with saline enema offers a radiation free alternative with a reported comparable success rate. The aim of this study is to evaluate the success rate and complications of this technique. Methods: This is a retrospective cohort of 632 intussusception patients in Mansoura University Children’s Hospital. All patients were managed by hydrostatic reduction under sonographic guidance with sedation. Patients who had sings of peritonitis, marked abdominal distension, high fever or lethargy were referred to surgical intervention and thus excluded from the study. Failure of the technique was equivalent to the need for surgery. Patients’ data was collected and analyzed. Indices for success were also calculated for a standardized success rate. Results: The success rate was 80.7% whether after one or more trails. Perforation rate was 3.5%. recurrence rate was 4.1%. Patients who went primarily for surgery was 19.2% hence were excluded from the results. Crude reduction rate was 68%. The selective reduction rate was 80.7%. The Corrected selective reduction rate was higher (88.5%). The composite reduction rate was 79.8%. Conclusion: Saline enema reduction offers an effective and safe alternative to other types of reduction. The technique has the advantage of avoiding exposure to radiation. Complications are of low rate and easily manageable.