Practitioners caring for pediatric transplant patients face unique issues compared with adult transplant providers. Distinct challenges to pediatric providers include incomplete or missed primary immunizations, lack of primary immunity to common illnesses, inability to definitively determine infectious serostatus in infants, and recognition of pediatric-specific disease states. Further, the lack of pediatric indications and dosing data for antimicrobials as well as variations in pediatric pharmacokinetics and drug exposure target levels complicates the treatment of infectious diseases in pediatric patients. As the field of pediatric transplantation continues to expand, additional pediatric data will guide best practices in the field, and pediatric-specific recommendations will increase.