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PURPOSE To quantify the macular microvasculature in healthy children of various ages using optical coherence tomography angiography (OCTA) DESIGN: Prospective cross-sectional study. METHODS 333 normal children aged from 4 to 16 years old were included. OCTA was performed on a 3 X 3 mm area centered on the macular region. Vascular density, perfusion density, fovea avascular zone (FAZ) area, FAZ perimeter and FAZ acircularity index (AI) were measured and adjusted for axial length. The differences were compared among various ages. RESULTS Among the different age groups, macular vascular density and perfusion density both increased with age. (P<0.0001 and P=0.0028) After adjusted for the spherical equivalent (SE) and axial length, macular vascular density was significantly associated with age. (r=0.183, P=0.001) No factors were significantly correlated with the perfusion density after adjusted for the age, SE, or axial length. The FAZ area and FAZ perimeter did not change among groups with different ages. Nevertheless, the AI of FAZ in the 4.00-6.99-year-old group was smaller than that of the 13.00-15.99-year-old group. (P=0.03) Younger children had significantly higher rates of inconsecutive vessels branched towards the macular center (P=0.0002) and vascular loops contributing to irregular shape of FAZ (P=0.024). CONCLUSIONS Macular vascular density and perfusion density continuously increases with age in children. Despite that FAZ area and perimeter did not change, the microstructure of FAZ pruned and tended to form a smooth and regular avascular area during development.