PURPOSE: To evaluate the retinal vasculature in pediatric patients with X-linked retinoschisis (XLRS) DESIGN: Retrospective consecutive case series SUBJECTS: Pediatric patients with a diagnosis of XLRS who had undergone wide-field fluorescein angiography (FA). METHODS: The electronic medical records of pediatric patients with XLRS at a tertiary referral eye center were reviewed from January 2015 to December 2021. Fluorescein angiography images were reviewed for anomalies of the retinal vasculature. MAIN OUTCOMES: Vascular anomalies on FA were recorded including capillary dropout/ischemia, terminal supernumerary vessels, vascular leakage, abnormal vascular loops, straightening of vessels, aberrant circumferential vessels, and neovascularization. RESULTS: In total, 29 eyes of 15 patients were included in the study (one patient had a phthisical eye). On FA, the most common findings were capillary dropout/ischemia (21 of 29 eyes, 72.4%), terminal supernumerary vessels (21 eyes, 72.4%), abnormal vascular loops (20 eyes, 69%), and vascular leakage (17 eyes, 58.6%). Of the 17 eyes with leakage, the most posterior zone of involvement was Zone 1 in 11 eyes (64.7%) and Zone 2 in 6 eyes (35.3%). All eyes demonstrated at least one vascular anomaly on FA. Among the 29 eyes, 23 (79.3%) demonstrated peripheral bullous schisis or retinal detachment with a mean of 5.6 clock hours of involvement. The presence of either retinal detachment or bullous retinal schisis was associated with the incidence of capillary dropout (91.3% in schisis/RD eyes vs 0% in non-schisis/RD eyes, p<0.001). Among those with retinal detachment or bullous schisis, a higher degree of involvement correlated with more severe capillary dropout (Pearson 0.49, p=0.025). CONCLUSIONS: The present study demonstrates consistent vascular changes in pediatric patients with XLRS using wide-field FA. While the presence of capillary ischemia was associated with the severity of bullous schisis or retinal detachment, other vascular anomalies were seen in patients both with and without peripheral schisis. Though further research is needed to understand the etiology of these vascular anomalies, FA should be considered in the evaluation of these patients.