Refeeding syndrome, a critical condition in undernourished patients, is characterized by metabolic and electrolyte imbalances that occur upon reintroducing nutrition after a period of prolonged fasting. This syndrome, which includes hypophosphatemia, hypokalemia, hypomagnesemia, and thiamine deficiency, frequently affects critically ill pediatric patients who are often at risk of undernutrition due to various chronic or acute conditions. Despite its potential lethality, awareness and recognition of refeeding syndrome in this population remain low. This review addresses the clinical importance of refeeding syndrome in critically ill children and underscores the need for prevention and management strategies. Essential actions involve identifying patients at risk, reintroducing nutrition gradually, consistently monitoring serum electrolytes-especially phosphorus, potassium, and magnesium-and ensuring adequate supplementation, including thiamine. These recommendations are in line with the 2020 consensus guidelines from the American Society for Parenteral and Enteral Nutrition. The review calls attention to the frequently underestimated severity of refeeding syndrome in critically ill pediatric patients and urges the prompt development of comprehensive, evidence-based clinical protocols and educational strategies to enhance patient outcomes.