Over recent years piercing of parts of the body other than the earlobes has become more common among school children. This article seeks to explore the issues raised by the practice, particularly for the school nurse, who may be involved in the management of children with body piercing in school. An overview of the different types of body piercing is provided, as well as a discussion of the legal aspects of body piercing in children under the age of 18. The infectious and non-infectious complications that may arise are examined. The article also addresses some of the psychological issues around body piercing, in particular exploring what motivates children to have a piercing done, and looks at the evidence that associates body piercing with high risk behaviours in this age group. Finally, the article provides practical guidance to healthcare professionals about managing children with body piercings, looking in particular at steps that can be taken to promote safe healing and the avoidance of complications.