Task-based functional magnetic resonance imaging (fMRI) is an imaging technique based on blood oxygenation level-dependent imaging. Maps of brain activation are generated during the performance of designated tasks involving eloquent functions, such as motor, sensory, visual, auditory, and/or language. Optimal performance of fMRI in children requires consideration of multiple psychological and physiological parameters. Also, a solid technical understanding is needed for appropriate study design, implementation, processing, and interpretation. In this article, the authors review the key principles of fMRI technique, study design, data processing, and interpretation. The important clinical applications in the pediatric population will be highlighted, accompanied by example cases from their institution.