Necrotizing pneumonia (NP) in children is a severe and potentially life-threatening complication of community-acquired pneumonia. It is characterized by the breakdown of the affected lung parenchyma with the formation of cavities, often accompanied by empyema and bronchopleural fistulas. The disease is caused by the virulence factor of the causative agent or the host's susceptibility factor. The most common isolated causative agent in children is Streptococcus pneumoniae, and its incidence has increased manyfold in the last two decades. Necrotizing pneumonia usually develops in previously healthy children under the age of 5. Its clinical presentation does not differ significantly from uncomplicated pneumonia. Persistence and worsening of symptoms despite antimicrobial treatment is characteristic for NP. The diagnosis is made by imaging tests of the chest, of which CT has proven to be the most accurate. Although the treatment of NP primarily includes antibiotic therapy, in patients with continuous worsening of the disease with the development of parenchymal complications and failure of conservative treatment, surgical treatment is indicated. Lung resections of various extents (lobectomies, wedge resections) and lung decortications with debridement of the swollen parenchyma are most often used. In disease progression with the development of pleural effusion, empyema, pyopneumothorax and abscess, drainage is often performed. With the increase in the incidence of NP, the focus of experts is on the indications, time, type, extent and outcomes of surgical treatment. Our knowledge about the treatment is limited by the results of individual case reports and researches on small groups of patients. The aim of this paper is to review knowledge about necrotizing pneumonia in children, especially those that require surgical treatment.