Background: Once diagnosis of malignancy is made in pediatric patients, it can be important to initiate therapy to prevent delay in benefits derived from treatment. These patients require provision of central vascular access to begin treatment. The aim of this study was to compare vascular access provision by a designated PVAT with surgical placement of central venous access in pediatric oncology patients. Methods: This was an IRB-approved retrospective medical record review of subjects diagnosed with an oncologic malignancy with inclusion criteria: ages 0-21 years of age, treatment for pediatric malignancy at the University of Maryland Children’s Hospital between 1/1/2017-12/31/2019. Results: We identified 69 patients who met the inclusion criteria with 39% (n=27) having undergone line placement by PVAT. The mean time from consult to line placement was 10 hours (SD = 9) in the PVAT group vs 76 hours (SD = 56) in the surgery group (p < 0.0001). There was a statistically significant difference in length of procedure, with PVAT placement requiring less time (27 +/- 12 minutes) vs surgical placement (48 +/- 19 minutes), p=0.0005. Conclusion: At our institution, having a PVAT in house has allowed for more efficient line placements, decreased length of time to provision of access and transition to placement of surgical lines when more stable. This allows for not only patients to receive care faster, but also to have lines placed in shorter times while optimizing patient safety.