Introduction: Hirschsprung disease is a common cause of intestinal obstruction during the neonatal period. The clinical picture can be quite varied. The current study is one of the large case series describing the clinic-pathological features, course and outcomes of Hirschsprung disease in paediatric population admitted in a larger Tertiary care paediatric surgery unit in the eastern part of India. Material and Method: This retrospective cohort study was conducted in the Department of Paediatric Surgery at Nilratan Sircar Medical College __ampersandsignamp; Hospital, Kolkata. The clinical data from paediatric Patients diagnosed with Hirschsprung disease who have undergone surgical procedures were collected from August 2011 to April 2013. Patients were excluded if surgical procedures could not be done or in case of death before the procedure. Data related to Clinical presentation, various outcomes following Operative procedures and post-operative complications were retrieved and analysed. Result: One hundred and forty-eight patients with Hirschsprung Disease were included in the study. About 52% of all patients were neonates and nearly 80% of all patients presented before infancy. Nearly three fourth of patients were male. Acute in testinal obstruction was the most common clinical presentation (58.1%). About 60% of all cases were found to have classical rectosigmoid involvement on pathological examination. Exploratory laparotomy with stoma during infancy followed by Duhamel procedure during the later period was the surgical procedure performed in the majority of cases. Intestinal perforation was found in 12 cases before surgical procedure, with Caecum being the commonest site of perforation (33.3%) followed by the transverse colon (16.6%). Conclusion: Clinical presentations of Hirschsprung disease are quite varied, sometimes may be nonspecific. Bowel perforation can be a rare but life-threatening presentation. Duhamel procedure is a safe and effective surgical approach and associated with few complications.