Pediatric disaster preparedness implies that systems are in place to ensure the rapid triage and emergency management of children as patients in a natural, manmade, or terrorist-initiated disaster. Children are a vulnerable population for a number of reasons that include anatomic, physiologic, immunologic, developmental and psychologic issues that are important for planning for the care of children in disasters or multicasualty incidents. Data suggest that more than one third of victims of disasters or multicasualty incidents are children, yet system planning has not included pediatric issues.Although there are challenges, lessons learned can be applied to current system planning that provides an opportunity within emergency and trauma care systems to plan more effectively, and then evaluate our strategies, policies, and procedures in simulated or real disaster scenarios.