OBJECTIVES: The risk of persistent symptoms following SARS-CoV-2 infection is observed, and the burden of long COVID to healthcare system is poorly characterized in this age group. We aimed to assess the healthcare resources utilization (HCRU) and costs associated with community-managed long COVID in children in France. Methods: We conducted a retrospective cohort study using the electronic records of confirmed and/or probable COVID-19 patients in the primary care setting from The Health Improvement Network (THIN) data between 03/2020 and 08/2023. Long-COVID was defined per World Health Organization (WHO) with suggestive symptoms given ≥12 weeks following acute SARS-CoV-2 infection. Patients’ characteristics, HCRU and costs were summarized. Results: A total of 27,537 children were included and 14.1% have long COVID. The mean (SD) age was 9(±5) years old with 26% being aged 6mos-4 yr, 37% aged 5-11 yr and 37% aged 12-17 yr, 49% were female and less than 1% had a Charlson Comorbidity Index (CCI) >2. The average follow-up was 13 months. Most of the patients (96%) had consultations with general practitioners (GPs), followed by nursing care (34%) and pediatrician (15%). HCRU & costs were the highest in the 1st year after long COVID diagnosis with per patient per year cost at €823, including consultations by GP at €187 and specialists at €78, outpatient procedures at €120, treatments at €216, laboratory tests at €52 and medical devices at €55. Conclusions: In children, long COVID poses a nontrivial burden to the FR health system, highlighting the importance of managing pediatric patients in primary care setting after acute infection, reducing the consequences of long COVID.