The emergency management of seizures often involves the use of diazepam as a first-line medication. Intravenous access is difficult in pediatric patients who are having seizures, and for this reason alternate routes of administration have been sought. This paper reviews the recent literature concerning the efficacy of rectal administration of intravenous diazepam solution for the purpose of emergency management of seizures in children. Although intravenous diazepam is the preferred route for the child with active seizure activity, undiluted diazepam intravenous solution administered per rectum is an excellent alternative. The technique of administration is reviewed.