With the exception of oral medications, most traditional forms of drug delivery outside the operating suite require an injection with a needle-a process that is painful and anxiety-provoking, risks needle stick injury, and consumes valuable staff time. In addition, intravenous access in pediatrics may be difficult for inexperienced providers. Intranasal medication delivery offers an alternative method of drug delivery that is often as fast in onset as intravenous medication, usually painless, inexpensive, easy to deliver, and effective in a variety of acute pediatric medical conditions. This article briefly reviews the most common uses for intranasal medication delivery in pediatrics: pain control, anxiolysis, and seizure control.