Background Early recurrent intussusception (RI) is a concern after a successful pneumatic reduction. Steroids have been suggested as a treatment that decreases early RI. The purpose of this study was to examine the role of dexamethasone in decreasing early RI. Methods A retrospective review of 174 pediatric patients that underwent successful pneumatic reduction was conducted. Two groups were identified: group 1 that received intravenous dexamethasone (0.5 mg/kg/dose) on diagnosis or immediately after the reduction maneuver, and group 2 that were not given dexamethasone. Results There were 113 boys and 61 girls ranging in age from 2 to 36 months. There were no statistical differences between the groups except for younger age in the dexamethasone group (P = 0.03). There was no significant difference (p = 0.08) in the rate of early RI between the non-steroid group (5.4%, 4/74) and the steroid group 14% (14/100). Mean admission length was 30 h. The majority of RIs occurred in the first 8 h of admission. Conclusions We found that premedication of children with idiopathic intussusception with dexamethasone did not decrease early RI. Level of evidence Level III retrospective comparative study.