Several studies carried out in recent years have provided increasing evidence for the great disease burden of influenza in children. During annual outbreaks, the attack rates of influenza are highest in children. Influenza frequently gives rise to bacterial complications such as acute otitis media, and young children are hospitalized for influenza-related illnesses at rates comparable to those seen in the elderly. Children also have a central role in the spread of influenza in the community, and the socioeconomic impact of pediatric influenza on children and on their household members is substantial. The great impact of influenza on children calls for increased attention to effective management of this illness in the youngest age groups. Influenza vaccination of young children is currently recommended in some countries (eg, the United States, Canada, and Finland) but despite the recommendations the vaccination rates remain low in many areas. For the treatment of influenza, the neuraminidase inhibitor oseltamivir is licensed for use in children 1 year of age or older. When started within 48 hours of the onset of symptoms, oseltamivir treatment shortens the duration of influenza by 1.5 days and reduces the development of acute otitis media as a complication by more than 40%. Neuraminidase inhibitors are also effective for postcontact prophylaxis of influenza in the family setting. The difficulty of diagnosing influenza on clinical grounds alone is an important limiting factor for the institution of antiviral treatment in young children. This is particularly true for the primary care where the routine use of influenza rapid tests for all febrile patients during a busy epidemic period may not be feasible.