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The therapeutic relationship is central to psychodynamic child therapy, which supports the children’s capacity to explore their inner world and form more secure ways of relating. However, there are frequent ruptures in the therapist-child relationship and their resolution is key to therapeutic progress. This study is the first to investigate alliance rupture resolution in psychodynamic child therapy with 50 Turkish school-age children. The kinds of ruptures and their resolution unique to child therapy, their associations with global alliance characteristics of the sessions, and children’s baseline demographic and clinical characteristics were assessed. It was found that withdrawal ruptures were more common compared to confrontation ruptures. Rupture and resolution markers showed significant associations with self-report and observer-rated alliance measures. Older children showed less frequent ruptures, which were resolved more effectively. Boys showed more frequent confrontation ruptures. The therapist’s contribution to ruptures was more significant with children who have externalizing problems. Lastly, children with emotion regulation problems showed more withdrawal ruptures. Therapists addressed the ruptures by maintaining a validating and empathic stance and by being curious about the patient’s perspective. Findings suggest that ruptures commonly occur in psychodynamic child therapy, and children’s unique clinical characteristics affect the types of ruptures that are observed.