Introduction. The incidence of priapism in adults is higher than in children. Although approximately 50% of all episodes of priapism are thought to be idiopathic, there are a number of known specific causes of this disorder. In adults intracavernous therapy with papaverine, phentolamine, alprostadil or combinations of these agents is the most common cause of ischemic priapism. In children the most common etiology is sickle cell anemia for low-flow priapism or post-traumatic high-flow priapism. We present a 13-year-old boy, not sexually active presented to our outpatient clinic suffering from long standing (3.5 hours) sustained painful erection. To the best of our knowledge the idiopathic low-flow priapism in pre-pubertal boy was not reported before in literature. Our case is the first case to be reported in pre-pubertal age. Conclusion. In pre-pubertal boys idiopathic recurrent priapism is a rare condition. In the literature, several empirical therapies are described. Recently, it is postulated that a low dose of a PDE5 inhibitor. The early conservative management is the best treatment option to safe the corporeal smooth muscles from irreversible damage.