Peristonsillar abscess (PTA) is a common deep neck space infection in children. Children with PTA often present with sore throat, dysphagia, peritonsillar bulge, uvular deviation, trismus, and a muffled voice. The diagnosis of PTA can be made based on history and physical examination in the majority of children. Treatment of pediatric PTA necessitates aspiration or surgical drainage and antibiotic therapy. Challenges exist with the diagnosis and management of PTA that are unique to pediatric patients. Examples include difficulty with examination of the oropharynx in an uncooperative child and controversy surrounding bedside needle aspiration verses operative incision and drainage. Early identification of PTA and initiation of appropriate treatment can prevent serious complications.